Near-infrared spectroscopy extended with indocyanine green dye dilution for cerebral blood flow measurement: Median values in healthy volunteers

Mudra, Regina; Muroi, Carl; Niederer, Peter F.; Keller, Emanuela

doi:10.2478/s11772-008-0027-y

Cited by 5 publications

(11 citation statements)

References 43 publications

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“…It has been previously reported that the ICG bolus-tracking method combined with CW-NIRS underestimates CBF in adults by a factor of 3 due primarily to the overestimation of the optical path length through brain tissue. 13,14 Improved depth sensitivity has been achieved using photon time-of-flight information measured directly by time-resolved ͑TR͒ techniques, or indirectly through phase changes measured by frequency-domain ͑FD͒ techniques. [15][16][17][18] The depth sensitivity made available by these techniques is due to the fact that early arriving photons travel shorter distances ͑i.e., through superficial tissue͒, while late arriving photons travel longer distances ͑i.e., deeper into brain tissue͒.…”

Section: Introductionmentioning

confidence: 99%

Comparison of time-resolved and continuous-wave near-infrared techniques for measuring cerebral blood flow in piglets

et al. 2010

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Abstract.A primary focus of neurointensive care is monitoring the injured brain to detect harmful events that can impair cerebral blood flow ͑CBF͒, resulting in further injury. Since current noninvasive methods used in the clinic can only assess blood flow indirectly, the goal of this research is to develop an optical technique for measuring absolute CBF. A time-resolved near-infrared ͑TR-NIR͒ apparatus is built and CBF is determined by a bolus-tracking method using indocyanine green as an intravascular flow tracer. As a first step in the validation of this technique, CBF is measured in newborn piglets to avoid signal contamination from extracerebral tissue. Measurements are acquired under three conditions: normocapnia, hypercapnia, and following carotid occlusion. For comparison, CBF is concurrently measured by a previously developed continuous-wave NIR method. A strong correlation between CBF measurements from the two techniques is revealed with a slope of 0.79± 0.06, an intercept of −2.2± 2.5 ml/ 100 g / min, and an R 2 of 0.810± 0.088. Results demonstrate that TR-NIR can measure CBF with reasonable accuracy and is sensitive to flow changes. The discrepancy between the two methods at higher CBF could be caused by differences in depth sensitivities between continuous-wave and time-resolved measurements. © 2010 Society of Photo-Optical Instrumentation Engineers.

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Section: Introductionmentioning

confidence: 99%

Comparison of time-resolved and continuous-wave near-infrared techniques for measuring cerebral blood flow in piglets

et al. 2010

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“…This method was used on an optical signal collected with probes on the scalp and inside the skull. 30–32…”

Section: Cerebral Blood Flowmentioning

confidence: 99%

“…Based on the modified Beer–Lambert law, the ICG concentration in the tissue citalicICGitalictissue was linked to the change in OD before and after the ICG injection 30 where italicDPF is the differential pathlength factor and d is the distance between the source and the detector.…”

Section: Cerebral Blood Flowmentioning

confidence: 99%

“…The optical properties of ICG upon injection are unstable due to the inhomogeneous distribution of the dye in the blood, which affects the OD analysis at the beginning of the recording. 30 The accuracy of equation (8) can be enhanced by considering this instability using a value, italicCdo, which retrospectively analyses the OD at the beginning of the injection based on the stabilized optical properties subsequent to sufficient intermixing of ICG and blood 30 …”

Section: Cerebral Blood Flowmentioning

confidence: 99%

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Cerebral perfusion and blood–brain barrier assessment in brain trauma using contrast-enhanced near-infrared spectroscopy with indocyanine green: A review

Forcione

Chiarelli

Davies

et al. 2020

J Cereb Blood Flow Metab

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Contrast-enhanced near-infrared spectroscopy (NIRS) with indocyanine green (ICG) can be a valid non-invasive, continuous, bedside neuromonitoring tool. However, its usage in moderate and severe traumatic brain injury (TBI) patients can be unprecise due to their clinical status. This review is targeted at researchers and clinicians involved in the development and application of contrast-enhanced NIRS for the care of TBI patients and can be used to design future studies. This review describes the methods developed to monitor the brain perfusion and the blood–brain barrier integrity using the changes of diffuse reflectance during the ICG passage and the results on studies in animals and humans. The limitations in accuracy of these methods when applied on TBI patients and the proposed solutions to overcome them are discussed. Finally, the analysis of relative parameters is proposed as a valid alternative over absolute values to address some current clinical needs in brain trauma care. In conclusion, care should be taken in the translation of the optical signal into absolute physiological parameters of TBI patients, as their clinical status must be taken into consideration. Discussion on where and how future studies should be directed to effectively incorporate contrast-enhanced NIRS into brain trauma care is given.

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“…Own examinations in 10 healthy volunteers allowed the definition of normal values with the new measurement setting [122]. ICG (0.5mg per kg bodyweight) was injected into the antecubital vein.…”

Section: Normal Values Critical Thresholdsmentioning

confidence: 99%

Measurement of Cerebral Blood Flow with Near Infrared Spectroscopy and Indocyanine Green Dye Dilution

Keller¹,

Mudra

2007

CMIR

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Early detection and treatment of cerebral ischemia to prevent further neurological damage in patients with severe brain injuries, such as in trauma and stroke patients, is one of the most important issues in Neurocritical Care. Our own clinical experiences in treatment of patients with severe ischemic stroke and subarachnoid hemorrhage have shown that the available methods to monitor cerebral hemodynamics and oxygenation are insufficient with regard to detection of secondary ischemic events. The established methods for bedside monitoring of cerebral blood flow (CBF) and cerebral oxygenation are difficult to perform clinically, involve radioactive radiation, are invasive or require the patient to be transported, thus involving potentially high risks. Transcranial Doppler sonography produces indices that can be related to changes in CBF and cerebral oxygenation but does not measure actual flow rates.During recent years, near infrared spectroscopy (NIRS) was further developed and supplemented with the indocyanine green (ICG) dye dilution mode for bedside monitoring of CBF. The NIRS ICG dye dilution technique is a promising method for serial bedside CBF measurements in the environment of the intensive care unit. The NIRS method with optodes on the skin has the advantage of being non invasive, does not require the patient to be transported and provides data at the bedside within minutes.Preliminary data in a limited number of volunteers indicate that CBF measurements obtained by NIRS ICG dye dilution technique are in agreement with corresponding values obtained by perfusion-weighted MRI. More patient-validated data by correlating the measurement values with clinical events and comparing them with standard methods are needed. For the accuracy of absolute measurements and in order to quantify the individual extracerebral pathlengths as well as to allow appropriate correction to be made for extracerebral dead space tissue further modelling based on patients data is required.New-generation NIRS instrumentation, implementing spatially resolved spectroscopy (SRS), depth-resolved technologies and invasive NIRS probes will give the opportunity to reduce or eliminate extracerebral contamination and will provide some unique physiological information for NIRS technology. To calculate the influence of extracerebral contamination comparative measurements can be performed using noninvasive NIRS probes on the scalp and invasive probes for NIRS and intracranial pressure (ICP) monitoring. Combined monitoring of ICP and NIRS will be of special clinical value in patients with severe stroke, subarachnoid hemorrhage and head trauma, already provided with ICP probes for treatment of intracranial hypertension and being especially at risk for secondary ischemic brain damage.

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Near-infrared spectroscopy extended with indocyanine green dye dilution for cerebral blood flow measurement: Median values in healthy volunteers

Cited by 5 publications

References 43 publications

Comparison of time-resolved and continuous-wave near-infrared techniques for measuring cerebral blood flow in piglets

Comparison of time-resolved and continuous-wave near-infrared techniques for measuring cerebral blood flow in piglets

Cerebral perfusion and blood–brain barrier assessment in brain trauma using contrast-enhanced near-infrared spectroscopy with indocyanine green: A review

Measurement of Cerebral Blood Flow with Near Infrared Spectroscopy and Indocyanine Green Dye Dilution

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