Hemodynamic models connect cerebral blood flow and oxygen metabolism with deoxy-hemoglobin and oxyhemoglobin measured by near-infrared spectroscopy (NIRS) to analyze cerebral hemodynamics. These models elucidate the relationship between physiological processes and NIRS signals, capturing changes in cerebral blood volume, flow, and oxygen metabolism. In our study, we explore microvasculature compartments and apply these models to NIRS data during pig cardiac arrest and cardiopulmonary resuscitation. Our goals were to validate the model and to understand the behavior of cerebral microvasculature and metabolism during cardiac arrest and resuscitation. By employing the inverse of the hemodynamic model, we measure a range of significant physiological parameters.
Two-thirds of out-of-hospital cardiac arrest patients, who survive to hospital admission, die in the hospital from neurological injuries related to cerebral hypoperfusion. Therefore, noninvasive real-time monitoring of the cerebral oxygen metabolism in cardiac arrest patients is extremely important. Hyperspectral near-infrared spectroscopy (hNIRS) is a noninvasive technique that measures concentrations of the key chromophores in the brain, such as oxygenated hemoglobin, deoxygenated hemoglobin, and cytochrome C oxidase (CCO), an intracellular marker of oxygen consumption. We tested hNIRS on 10 patients undergoing transcatheter aortic valve insertion, where rapid ventricular pacing (RVP) is required to temporarily induce sudden hypotension and hypoperfusion that mimic cardiac arrest. Using multidistance hNIRS, we found that tissue oxygen saturation changes in the cerebral tissue were lower than those in the scalp during RVP. CCO redox changes were detected in cerebral tissue but not in the scalp during RVP. We have demonstrated that hNIRS is feasible and can detect sudden changes in cerebral oxygenation and metabolism in patients during profound hypotension.
Two-thirds of out-of-hospital cardiac arrest patients, who survive to hospital admission, die in the hospital from neurological injuries related to cerebral hypoperfusion. Hyperspectral near infrared spectroscopy (hNIRS) is a noninvasive technique that measures the major chromophores in the brain, such as oxygenated hemoglobin, deoxygenated hemoglobin and cytochrome C oxidase ([CCO]), an intracellular marker of oxygen consumption. We have demonstrated that hNIRS is feasible and can detect changes in cerebral oxygenation and metabolism in patients undergoing transcatheter aortic valve insertion (TAVI) – a procedure that temporarily induces sudden hypotension and hypoperfusion that mimics cardiac arrest. Using multi-distance hNIRS, we found that while measured regional oxygen saturation (rSO2) changes resulted mainly from the extra-cerebral tissues, [CCO] changes during cardiac arrests occurred mainly in the brains of patients. We also applied the hNIRS algorithm based on the “2-layer model” to the data to measure cerebral oxygen saturation and [CCO] in patients during the procedure.
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