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A laser Doppler system for monitoring cerebral microcirculation: implementation and evaluation during neurosurgery

Abstract

The aim of this study was to adapt and evaluate laser Doppler perfusion monitoring (LDPM) together with custom-designed brain probes and software for continuous recording of cerebral microcirculation in patients undergoing neurosurgery. The LDPM system was used to record perfusion and backscattered light (TLI). These parameters were displayed together with the extracted heart rate (HR), pulsatility index (PI) and signal trends from adjustable time intervals. Technical evaluation was done on skin during thermal provocation. Clinical measurements were performed on ten patients undergoing brain tumour surgery. Data from 76 tissue sites were captured with a length varying between 10 s to 15 min. Statistical comparisons were done using Mann–Whitney tests. Grey and tumour tissue could be separated from white matter using the TLI signal (p < 0.05). The perfusion was significantly higher in grey and tumour tissue compared to white matter (p < 0.005). LDPM was successfully used as an intraoperative tool for monitoring local blood flow and additional parameters linked to cerebral microcirculation (perfusion, TLI, HR and PI) during tumour resection. The systems stability opens up for studies in the postoperative care of patients with, for example, traumatic brain injury or subarachnoid haemorrhage.

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Acknowledgments

The authors would like to thank the clinical staff at the Neurosurgical Department of Linköping University Hospital for their help during the surgical measurements. The authors also acknowledge research engineer Mats Andersson and Per Sveider at the Department of Biomedical Engineering for skilful fabrication of the custom optical probes. This study was supported by the Swedish Research Council (Grant No. 6212-010-4216).

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Peter Rejmstad.

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Rejmstad, P., Åkesson, G., Åneman, O. et al. A laser Doppler system for monitoring cerebral microcirculation: implementation and evaluation during neurosurgery. Med Biol Eng Comput 54, 123–131 (2016). https://doi.org/10.1007/s11517-015-1332-5

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Keywords

  • Microcirculation
  • Brain tumour
  • Laser Doppler perfusion monitoring (LDPM)
  • Pulsatility index (PI)
  • Neurosurgery