This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions.
Endothelial dysfunction represents a key factor in the worsening of the COVID-19 disease in up to 20% of the cases of infection from acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2). The combination of diffuse optics and vascular occlusion tests makes the assessment of endothelial and microvasculature health possible by accessing information about microvascular metabolism, reactivity and tissue perfusion just by performing a localized ischemia at the forearm of the patient. In this framework, we will present a smart platform integrating time-domain near-infrared spectroscopy and diffuse correlation spectroscopy alongside an automatized tourniquet and a pulse-oximeter for personalizing therapies targeting endothelial function and avoid ventilator-induced lung injuries.
The HEMOCOVID-19 clinical trial, carried out in 10 hospitals from 5 countries, aims to non-invasively assess, through continuous-wave near-infrared spectroscopy (CW-NIRS), the microvascular and endothelial health in COVID-19 patients admitted to intensive care. We achieve this by performing a vascular occlusion test on the forearm muscle while continuously measuring local tissue oxygen saturation and hemoglobin concentration. We found significant alterations in systemic microcirculation of COVID-19 patients with respect to healthy subjects (i.e. slower deoxygenation during the ischemia and reoxygenation after releasing the cuff, and lower hyperemic response). In addition, we found that, within the group of COVID-19 patients, the systemic microcirculation alterations correlate with severity of pulmonary disease.
KEYWORDS: Near infrared spectroscopy, Continuous wave operation, Measurement devices, Medical devices, In vivo imaging, Tissues, Tissue optics, Spectroscopes, Reliability, Oxygen
During the first peak of the COVID-19 pandemic, we have set up a clinical campaign in ten hospitals worldwide to assess the endothelial health of COVID-19 patients using commercial continuous-wave near-infrared spectroscopy (CW-NIRS) devices (PortaMon, Artinis, NL). In spite of the wide range of clinical applications, the reliability of common CW-NIRS systems for absolute oxygenation measurements was often questioned, opening issues of standardization. In addition, a multi-center trial itself opens issues about how to compare measurements performed by different operators, in different conditions and longitudinally over more than a year. Here, we present how we address these challenges by characterizing and comparing the performance of the devices, with phantom and in vivo experiments.
The VASCOVID project aims to develop an hybrid diffuse optical device with a vascular occlusion protocol for evaluating endothelial and microvascular health in severe COVID-19 patients admitted to the ICU.
We present the HEMOCOVID-19 study spanning four countries and eight hospitals where near-infrared spectroscopy is utilized to evaluate microvascular and endothelial health of severe COVID-19 patients at the intensive care.
As coronavirus disease 2019 (COVID-19) has spread across the world, the surge in patients requiring ICU admission has been overwhelming.The rapid diagnosis and isolation, clinical management, and infection prevention are the main challenges associated with this pandemic. When the disease becomes critical, adequate management of acute respiratory failure and supporting the hemodynamics is key in order to minimize the negative impact on survival. However, many questions on prognosis and efficient clinical management remain unanswered. HEMOCOVID-19 uses near-infrared diffuse optical technologies to non-invasively evaluate endothelial and microvascular dysfunction to aid both the development of targeted therapies and also to personalize rescue therapies. HEMOCOVID-19 has eleven partners in four countries and is open for new members. I will present the project and the preliminary results. I will then briefly explain the vision for the longer-term.
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