Measurement of total hemoglobin concentration [Hgb] is a blood test that is widely used to evaluate outpatients, hospital inpatients, and surgical patients, especially those undergoing surgery associated with extensive blood loss, rapid fluid administration, and transfusion of packed red blood cells. Current techniques for measurement of [Hgb] are invasive (requiring blood sampling) and cannot provide real-time, continuous monitoring. We propose to use an optoacoustic technique for noninvasive and continuous monitoring of [Hgb]. The high resolution of the optoacoustic technique may provide accurate measurement of [Hgb] by detection and analysis of optoacoustic signals induced by short optical pulses in blood circulating in arteries or veins. We designed, built, and tested in vitro (in both tissue phantoms and in preliminary in vivo experiments) a portable optoacoustic system for the monitoring of [Hgb] in the radial artery. The system includes a nanosecond laser operating in the near-infrared spectral range and a sensitive optoacoustic probe designed to irradiate the radial artery through the skin and detect optoacoustic signals induced in blood. Results of our studies demonstrated that (1) the slope of optoacoustic waves induced in blood in the transmission mode is linearly dependent on [Hgb] in the range from 6.2 to 12.4 g/dl, (2) optoacoustic signals can be detected despite optical attenuation in turbid tissue phantoms with a thickness of 1 cm, and (3) the optoacoustic system detects signals induced in blood circulating in the radial artery. These data suggest that the optoacoustic system can be used for accurate, noninvasive, real-time, and continuous monitoring of [Hgb].

Noninvasive monitoring of cerebral blood oxygenation with an optoacoustic technique offers advantages over current invasive and noninvasive methods. We report the results of in vivo studies in the sheep superior sagittal sinus (SSS), a large central cerebral vein. We changed blood oxygenation by increasing and decreasing the inspired fraction of oxygen (FiO(2)). Optoacoustic measurements from the SSS were performed at wavelengths of 700, 800, and 1064 nm using an optical parametric oscillator as a source of pulsed near-infrared light. Actual oxygenation of SSS blood was measured with a CO-Oximeter in blood samples drawn from the SSS through a small craniotomy. The amplitude of the optoacoustic signal induced in the SSS blood at lambda = 1064 nm closely followed the changes in blood oxygenation, at lambda = 800 nm was almost constant, and at lambda = 700 nm was changing in the opposite direction, all in accordance with the absorption spectra of oxy- and deoxyhemoglobin. The optoacoustically predicted oxygenation correlated well with actual blood oxygenation in sheep SSS (R(2) = 0.965 to 0.990). The accuracy was excellent, with a mean difference of 4.8% to 9.3% and a standard deviation of 2.8% to 4.2%. To the best of our knowledge, this paper reports for the first time accurate measurements of cerebral venous blood oxygenation validated against the "gold standard" CO-Oximetry method.

A noninvasive, high-resolution optoacoustic technique is a promising alternative to currently used invasive methods of brain oxygenation monitoring. We present the results of our pilot clinical test of this technique in healthy volunteers. Multiwavelength optoacoustic measurements (with nanosecond optical parametric oscillator as a source of radiation) were performed on the area of the neck overlying the internal jugular vein, a deeply located large vein that drains blood from the brain and from extracranial tissues. Optoacoustic signals induced in venous blood were measured with high resolution and signal-to-noise ratio despite the presence of a thick layer of overlying tissue (up to 10 mm). The characteristic parameters of the signal at different wavelengths correlated well with the spectrum of the effective attenuation coefficient of blood.

The optoacoustic technique is noninvasive, has high spatial resolution, and potentially can be used to measure the total hemoglobin concentration ([THb]) continuously and accurately. We performed in vitro measurements in blood and in vivo tests in healthy volunteers. Our clinical protocol included rapid infusion of intravenous saline to simulate rapid change in the [THb] during fluid therapy or surgery. Optoacoustic measurements were made from the wrist area overlying the radial artery for more than 1 h. The amplitude of the optoacoustic signal generated in the radial artery closely followed the [THb] measured directly in concurrently collected blood samples.

Monitoring (currently invasive) of cerebral venous blood oxygenation is a key to avoiding hypoxia-induced brain injury resulting in death or severe disability. Noninvasive, optoacoustic monitoring of cerebral venous blood oxygenation can potentially replace existing invasive methods. To the best of our knowledge, we report for the first time noninvasive monitoring of cerebral venous blood oxygenation through intact scalp that was validated with invasive, “gold standard” measurements. We performed an in vivo study in the sheep superior sagittal sinus (SSS), a large midline cerebral vein, using our novel, multi-wavelength optoacoustic system. The study results demonstrated that: 1) the optoacoustic signal from the sheep SSS is detectable through the thick, intact scalp and skull; 2) the SSS signal amplitude correlated well with wavelength and actual SSS blood oxygenation measured invasively using SSS catheterization, blood sampling, and measurement with “gold standard” CO-Oximeter; 3) the optoacoustically predicted oxygenation strongly correlated with that measured with the CO-Oximeter. Our results indicate that monitoring of cerebral venous blood oxygenation may be performed in humans noninvasively and accurately through the intact scalp using optoacoustic systems because the sheep scalp and skull thickness is comparable to that of humans whereas the sheep SSS is much smaller than that of humans.