The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspective
Objectives: Real-time noninvasive monitoring of cerebral blood flow (CBF) during surgery is key to reducing mortality rates associated with adult cardiac surgeries requiring hypothermic circulatory arrest (HCA). We explored a method to monitor cerebral blood flow during different brain protection te...
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Elsevier
2021-06-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250721000936 |
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| author | Alexander I. Zavriyev, BS Kutlu Kaya, MS Parisa Farzam, PhD Parya Y. Farzam, BS John Sunwoo, PhD Arminder S. Jassar, MBBS Thoralf M. Sundt, MD Stefan A. Carp, PhD Maria Angela Franceschini, PhD Jason Z. Qu, MD |
| author_facet | Alexander I. Zavriyev, BS Kutlu Kaya, MS Parisa Farzam, PhD Parya Y. Farzam, BS John Sunwoo, PhD Arminder S. Jassar, MBBS Thoralf M. Sundt, MD Stefan A. Carp, PhD Maria Angela Franceschini, PhD Jason Z. Qu, MD |
| author_sort | Alexander I. Zavriyev, BS |
| collection | DOAJ |
| description | Objectives: Real-time noninvasive monitoring of cerebral blood flow (CBF) during surgery is key to reducing mortality rates associated with adult cardiac surgeries requiring hypothermic circulatory arrest (HCA). We explored a method to monitor cerebral blood flow during different brain protection techniques using diffuse correlation spectroscopy (DCS), a noninvasive optical technique which, combined with frequency-domain near-infrared spectroscopy (FDNIRS), also provides a measure of oxygen metabolism. Methods: We used DCS in combination with FDNIRS to simultaneously measure hemoglobin oxygen saturation (SO2), an index of cerebral blood flow (CBFi), and an index of cerebral metabolic rate of oxygen (CMRO2i) in 12 patients undergoing cardiac surgery with HCA. Results: Our measurements revealed that a negligible amount of blood is delivered to the cerebral cortex during HCA with retrograde cerebral perfusion, indistinguishable from HCA-only cases (median CBFi drops of 93% and 95%, respectively) with consequent similar decreases in SO2 (mean decrease of 0.6 ± 0.1% and 0.9 ± 0.2% per minute, respectively); CBFi and SO2 are mostly maintained with antegrade cerebral perfusion; the relationship of CMRO2i to temperature is given by CMRO2i = 0.052e0.079T. Conclusions: FDNIRS-DCS is able to detect changes in CBFi, SO2, and CMRO2i with intervention and can become a valuable tool for optimizing cerebral protection during HCA. |
| format | Article |
| id | doaj-art-ce798b171ddd43b4a49eadd162d9e8f5 |
| institution | DOAJ |
| issn | 2666-2507 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-ce798b171ddd43b4a49eadd162d9e8f52025-08-20T03:04:58ZengElsevierJTCVS Techniques2666-25072021-06-01716117710.1016/j.xjtc.2021.01.023The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspectiveAlexander I. Zavriyev, BS0Kutlu Kaya, MS1Parisa Farzam, PhD2Parya Y. Farzam, BS3John Sunwoo, PhD4Arminder S. Jassar, MBBS5Thoralf M. Sundt, MD6Stefan A. Carp, PhD7Maria Angela Franceschini, PhD8Jason Z. Qu, MD9Department of Radiology, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Address for reprints: Alexander I. Zavriyev, BS, 149 13th St, Charlestown, MA 02129.Department of Radiology, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MassDepartment of Radiology, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MassDepartment of Radiology, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MassDepartment of Radiology, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MassDivision of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MassDivision of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MassDepartment of Radiology, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MassDepartment of Radiology, Optics at Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MassDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MassObjectives: Real-time noninvasive monitoring of cerebral blood flow (CBF) during surgery is key to reducing mortality rates associated with adult cardiac surgeries requiring hypothermic circulatory arrest (HCA). We explored a method to monitor cerebral blood flow during different brain protection techniques using diffuse correlation spectroscopy (DCS), a noninvasive optical technique which, combined with frequency-domain near-infrared spectroscopy (FDNIRS), also provides a measure of oxygen metabolism. Methods: We used DCS in combination with FDNIRS to simultaneously measure hemoglobin oxygen saturation (SO2), an index of cerebral blood flow (CBFi), and an index of cerebral metabolic rate of oxygen (CMRO2i) in 12 patients undergoing cardiac surgery with HCA. Results: Our measurements revealed that a negligible amount of blood is delivered to the cerebral cortex during HCA with retrograde cerebral perfusion, indistinguishable from HCA-only cases (median CBFi drops of 93% and 95%, respectively) with consequent similar decreases in SO2 (mean decrease of 0.6 ± 0.1% and 0.9 ± 0.2% per minute, respectively); CBFi and SO2 are mostly maintained with antegrade cerebral perfusion; the relationship of CMRO2i to temperature is given by CMRO2i = 0.052e0.079T. Conclusions: FDNIRS-DCS is able to detect changes in CBFi, SO2, and CMRO2i with intervention and can become a valuable tool for optimizing cerebral protection during HCA.http://www.sciencedirect.com/science/article/pii/S2666250721000936antegrade cerebral perfusionbrain imagingcerebral blood flowdiffuse correlation spectroscopyhypothermic circulatory arrestnear-infrared spectroscopy |
| spellingShingle | Alexander I. Zavriyev, BS Kutlu Kaya, MS Parisa Farzam, PhD Parya Y. Farzam, BS John Sunwoo, PhD Arminder S. Jassar, MBBS Thoralf M. Sundt, MD Stefan A. Carp, PhD Maria Angela Franceschini, PhD Jason Z. Qu, MD The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspective JTCVS Techniques antegrade cerebral perfusion brain imaging cerebral blood flow diffuse correlation spectroscopy hypothermic circulatory arrest near-infrared spectroscopy |
| title | The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspective |
| title_full | The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspective |
| title_fullStr | The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspective |
| title_full_unstemmed | The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspective |
| title_short | The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestsCentral MessagePerspective |
| title_sort | role of diffuse correlation spectroscopy and frequency domain near infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrestscentral messageperspective |
| topic | antegrade cerebral perfusion brain imaging cerebral blood flow diffuse correlation spectroscopy hypothermic circulatory arrest near-infrared spectroscopy |
| url | http://www.sciencedirect.com/science/article/pii/S2666250721000936 |
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