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Regional Cerebral Abnormalities Measured by Frequency-Domain Near-Infrared Spectroscopy in Pediatric Patients During Extracorporeal Membrane Oxygenation

机译:儿科患者体外膜氧合期间频域近红外光谱法测量的区域性脑异常

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摘要

Extracorporeal membrane oxygenation (ECMO) is a form of advanced cardiorespiratory support provided to critically ill patients with severe respiratory or cardiovascular failure. While children undergoing ECMO therapy have significant risk for neurological morbidity, currently there is a lack of reliable bedside tool to detect the neurologic events for patients on ECMO. This study assessed the feasibility of frequency-domain near-infrared spectroscopy (NIRS) for detection of intracranial complications during ECMO therapy. The frequency-domain NIRS device measured the absorption coefficient (μa) and reduced scattering coefficient (μs′) at six cranial positions from seven pediatric patients (0–16 years) during ECMO support and five healthy controls (2–14 years). Regional abnormalities in both absorption and scattering were identified among ECMO patients. A main finding in this study is that the abnormalities in scattering appear to be associated with lower-than-normal μs′ values in regional areas of the brain. Because light scattering originates from the intracellular structures (such as nuclei and mitochondria), a reduction in scattering primarily reflects loss or decreased density of the brain matter. The results from this study indicate a potential to use the frequency-domain NIRS as a safe and complementary technology for detection of intracranial complications during ECMO therapy.
机译:体外膜氧合作用(ECMO)是向严重呼吸道或心血管衰竭重症患者提供的高级心肺支持服务。虽然接受ECMO治疗的儿童神经系统疾病的风险很高,但目前缺乏可靠的床旁工具来检测ECMO患者的神经系统事件。这项研究评估了频域近红外光谱(NIRS)在ECMO治疗期间检测颅内并发症的可行性。频域NIRS设备在ECMO支持期间和5名健康对照(2-14岁)期间测量了7名小儿患者(0-16岁)在六个颅骨位置的吸收系数(μa)和降低的散射系数(μs')。在ECMO患者中发现了吸收和散射的区域异常。这项研究的主要发现是,散射的异常似乎与大脑局部区域的μs'值低于正常值有关。因为光散射源自细胞内结构(例如细胞核和线粒体),所以散射的减少主要反映了脑物质的损失或密度降低。这项研究的结果表明,将频域NIRS用作在ECMO治疗期间检测颅内并发症的安全和补充技术的潜力。

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