Using near-infrared spectroscopy to monitor spinal cord oxygenation in the injured spinal cord

A. Cheung; L. Tu; N. Manouchehri; K. T. Kim; K. So; M. Webster; S. Fisk; S. Tigchelaar; S. S. Dalkilic; F. Streijger; A. Macnab; B. K. Kwon; B. Shadgan

doi:10.1117/12.2546577

14 February 2020 Using near-infrared spectroscopy to monitor spinal cord oxygenation in the injured spinal cord

A. Cheung, L. Tu, N. Manouchehri, K. T. Kim, K. So, M. Webster, S. Fisk, S. Tigchelaar, S. S. Dalkilic, F. Streijger, A. Macnab, B. K. Kwon, B. Shadgan

Author Affiliations +

Proceedings Volume 11247, Optical Diagnostics and Sensing XX: Toward Point-of-Care Diagnostics; 1124709 (2020) https://doi.org/10.1117/12.2546577
Event: SPIE BiOS, 2020, San Francisco, California, United States

Abstract

Introduction: Current clinical guidelines recommend augmenting the mean arterial pressure (MAP) in acute spinal cord injury (SCI) patients to increase perfusion and oxygen delivery to the spinal cord, and potentially improve neurologic function. However, it is difficult for clinicians to hemodynamically manage acute SCI patients without real-time physiologic information about the effect of MAP augmentation within the injured cord. In this study, we investigated the utilization of a customized optical sensor, based on near-infrared spectroscopy (NIRS), to non-invasively monitor spinal cord oxygenation during the first week post-injury in a porcine model. Methods: Six Yucatan mini-pigs received a weight-drop T10 contusion-compression injury. A multi-wavelength NIRS system with a custom-made miniaturized sensor was placed directly onto the dura. The spinal cord tissue oxygenation index (TOI) and concentrations of oxygenated, deoxygenated, and total hemoglobin were monitored before and after SCI. To validate the NIRS measures, invasive intraparenchymal (IP) combined PO2/blood flow sensors were inserted into the spinal cord adjacent to the NIRS sensor. Episodes of MAP alteration and hypoxia were performed acutely after injury, 2 days post-injury, and 7 days post-injury to simulate the types of hemodynamic changes SCI patients experience post-injury. Results: Non-invasive NIRS monitoring identified changes in spinal cord oxygenation levels during the MAP alterations. Changes of TOI followed similar patterns of IP-derived oxygenation changes. Conclusion: Our novel NIRS sensor is feasible as a non-invasive technique to monitor real-time changes in spinal cord oxygenation 7 days post-injury in a porcine model of SCI.

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A. Cheung, L. Tu, N. Manouchehri, K. T. Kim, K. So, M. Webster, S. Fisk, S. Tigchelaar, S. S. Dalkilic, F. Streijger, A. Macnab, B. K. Kwon, and B. Shadgan "Using near-infrared spectroscopy to monitor spinal cord oxygenation in the injured spinal cord", Proc. SPIE 11247, Optical Diagnostics and Sensing XX: Toward Point-of-Care Diagnostics, 1124709 (14 February 2020); https://doi.org/10.1117/12.2546577

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