Breakthrough in the assessment of cerebral perfusion and vascular permeability after brain trauma through the adoption of dynamic indocyanine green-enhanced near-infrared spectroscopy

Ganau, Mario; Iqbal, Mohammad; Ligarotti, Gianfranco K.I.; Syrmos, Nikolaos

doi:10.21037/qims-20-905

Cited by 9 publications

(4 citation statements)

References 30 publications

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“…PSH can be a devastating condition. PSH patients have higher mortality rates (OR = 0.08; 95% CI = 0.01–0.52) and tend to be older than other TBI patients (OR = 1.08; 95% CI = 1.00–1.16) [ 32 ]. In a retrospective study, Cotton et al [ 25 ] reported lower mortality rates with beta-blocker therapy despite older age, higher injury severity scores, and lower estimated probability of survival (5.1% vs. 10.8%, P =0.03).…”

Section: Discussionmentioning

confidence: 99%

Paroxysmal Sympathetic Hyperactivity in Moderate-to-Severe Traumatic Brain Injury and the Role of Beta-Blockers: A Scoping Review

Nguembu

Meloni²,

Endalle

et al. 2021

Emergency Medicine International

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Introduction. Most cases of paroxysmal sympathetic hyperactivity (PSH) result from traumatic brain injury (TBI). Little is known about its pathophysiology and treatment, and several neuroprotective drugs are used including beta-blockers. The aim of our study is to collate existing evidence of the role of beta-blockers in the treatment of PSH. Methods. We searched MEDLINE, ResearchGate, and Google Scholar, for keywords related to PSH and the role of beta-blockers in moderate-to-severe TBI on September 23, 2020. Two authors blindly screened the articles found with Rayyan. Both resolved their conflicts by mutual consent. If no solution was found, a third author was consulted. Simple descriptive data analysis was performed and the results were presented both in a narrative and tabular form. Results. Of the 19 items found, 10 met the criteria for inclusion. 50% were systematic reviews without meta-analysis, 40% were observational studies, and 10% were experimental studies. Propranolol was the main beta-blocker found in 80% of the studies and was the only molecule used in the treatment of paroxysmal sympathetic hyperactivity in 40% of the included studies. Only two studies evaluated and showed a significant association between beta-blockers and mortality rate (5.1% vs. 10.8%; P = 0.03 ), (3% vs. 15%; P = 0.002 ), respectively. Conclusion. Propranolol is the beta-blocker that has been shown to be effective in reducing the length of stay and mortality rate in moderate-severe traumatic brain injury patients with PSH. However, further studies are needed to precisely define the terms and conditions of its use.

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Section: Discussionmentioning

confidence: 99%

Paroxysmal Sympathetic Hyperactivity in Moderate-to-Severe Traumatic Brain Injury and the Role of Beta-Blockers: A Scoping Review

Nguembu

Meloni²,

Endalle

et al. 2021

Emergency Medicine International

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“…Brain injury often leads to different degrees of permanent dysfunction, mainly depending on the inducement and location of brain injury, such as spinal cord injury (77), traumatic brain injury (TBI) (78), inflammatory injury (79), brain injury and rehabilitation (80), and stroke injury (81). Different brain damage regions can cause different symptoms, including motor, sensory, verbal, visual, auditory abnormalities, memory, and sleep disturbance (82)(83)(84). Therefore, the brain injury location, vascular damage, and bleeding are very important for assessing the disease, the condition, and the expected treatment.…”

Section: Acute Brain Injurymentioning

confidence: 99%

Photoacoustic imaging as a highly efficient and precise imaging strategy for the evaluation of brain diseases

Qiu¹,

Lan²,

Gao³

et al. 2021

Quant Imaging Med Surg

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Photoacoustic imaging (PAI) is an emerging imaging strategy with a unique combination of rich optical contrasts, high ultrasound spatial resolution, and deep penetration depth without ionizing radiation.Taking advantage of the features mentioned above, PAI has been widely applied to preclinical studies in diverse fields, such as vascular biology, cardiology, neurology, ophthalmology, dermatology, gastroenterology, and oncology. Among various biomedical applications, photoacoustic brain imaging has great importance due to the brain's complex anatomy and the variability of brain disease. In this review, we aimed to introduce a novel and effective imaging modality for diagnosing brain diseases. Firstly, a brief overview of two major types of PAI system was provided. Then, PAI's major preclinical applications in brain diseases were introduced, including early diagnosis of brain tumors, subtle changes in the chemotherapy response, epileptic activity and brain injury, foreign body, and brain plaque. Finally, a perspective of the remaining challenges of PAI was given for future advancements.

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“…To facilitate the introduction of NIRS into clinical practice, future optical research studies should be framed in specific clinical scenarios [ 141 ]: this would help clinicians to interpret the physiological meaning of the optical values and to analyze them alongside other biomarkers from separate neuromonitoring techniques; the assessment of response to treatment can be facilitated by a targeted approach to specific subgroups of TBI patients.…”

Section: Future Application Of Tissue Partial Oxygen Pressure and mentioning

confidence: 99%

Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy

Forcione

Ganau

Prisco

et al. 2021

IJMS

Self Cite

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The brain tissue partial oxygen pressure (PbtO2) and near-infrared spectroscopy (NIRS) neuromonitoring are frequently compared in the management of acute moderate and severe traumatic brain injury patients; however, the relationship between their respective output parameters flows from the complex pathogenesis of tissue respiration after brain trauma. NIRS neuromonitoring overcomes certain limitations related to the heterogeneity of the pathology across the brain that cannot be adequately addressed by local-sample invasive neuromonitoring (e.g., PbtO2 neuromonitoring, microdialysis), and it allows clinicians to assess parameters that cannot otherwise be scanned. The anatomical co-registration of an NIRS signal with axial imaging (e.g., computerized tomography scan) enhances the optical signal, which can be changed by the anatomy of the lesions and the significance of the radiological assessment. These arguments led us to conclude that rather than aiming to substitute PbtO2 with tissue saturation, multiple types of NIRS should be included via multimodal systemic- and neuro-monitoring, whose values then are incorporated into biosignatures linked to patient status and prognosis. Discussion on the abnormalities in tissue respiration due to brain trauma and how they affect the PbtO2 and NIRS neuromonitoring is given.

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Breakthrough in the assessment of cerebral perfusion and vascular permeability after brain trauma through the adoption of dynamic indocyanine green-enhanced near-infrared spectroscopy

Cited by 9 publications

References 30 publications

Paroxysmal Sympathetic Hyperactivity in Moderate-to-Severe Traumatic Brain Injury and the Role of Beta-Blockers: A Scoping Review

Paroxysmal Sympathetic Hyperactivity in Moderate-to-Severe Traumatic Brain Injury and the Role of Beta-Blockers: A Scoping Review

Photoacoustic imaging as a highly efficient and precise imaging strategy for the evaluation of brain diseases

Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy

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