We examine the correlation of non-invasive, frequency-domain diffuse optical spectroscopy (FD-DOS) and diffuse correlation spectroscopy (DCS) measurements of cerebral tissue oxygen extraction fraction (OEF) and relative cerebral blood flow (rCBF) with invasive cerebral microdialysis measurement of the cerebral lactate-pyruvate ratio (LPR), a biomarker of metabolic stress, during extracorporeal membrane oxygenation (ECMO) in a pediatric swine model of ECMO assisted cardiopulmonary resuscitation (n=15). During 22-24 hours of ECMO, non-invasive FD-DOS/DCS neuromonitoring of OEF and rCBF demonstrated significant correlations with cerebral LPR. Non-invasive detection of critical neurometabolic stress at the bedside may facilitate brain-targeted ECMO management after cardiac arrest.
Mild hypothermic cardiopulmonary bypass (CPB) is used during neonatal cardiac surgery. To elucidate potential risk factors for brain injury, diffuse optical spectroscopy, diffuse correlation spectroscopy, and cerebral microdialysis techniques were employed to monitor cerebral hemodynamics during mild hypothermic CPB in a swine model. Optical metrics were further compared with microdialysis metrics. Stable microdialysis metabolite levels, a significant decrease in CMRO2, and trending (but not significant) decreases in CBF and increases in OEF were observed. This suggests that the optical metrics may be more sensitive to neurologic injury during CPB than microdialysis.
Extracorporeal membrane oxygenation (ECMO) is an important therapy for critically ill children but survivors have neurodevelopmental impairments. Cerebral inflammatory response resulting in brain edema is observed on ECMO. This pathologic response may adversely impact the quantitative accuracy of diffuse optical spectroscopy (DOS) neuromonitoring (including commercial NIRS) which commonly assumes a 75% water fraction. Using fresh brain tissue desiccation, we directly quantified the severity of cerebral edema in pediatric swine following cardiac arrest, CPR and 22-24 hours of ECMO therapy. The fractional error in DOS quantification of cerebral hemodynamics from assuming 75% water fraction was determined to be <5%.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.