title: Tissue hemoglobin monitoring of progressive central hypovolemia in humans using broadband diffuse optical spectroscopy.
abstract: We demonstrate noninvasive near-infrared diffuse optical spectroscopy (DOS) measurements of tissue hemoglobin contents that can track progressive reductions in central blood volume in human volunteers. Measurements of mean arterial blood pressure (MAP), heart rate (HR), stroke volume (SV), and cardiac output (Q) are obtained in ten healthy human subjects during baseline supine rest and exposure to progressive reductions of central blood volume produced by application of lower body negative pressure (LBNP). Simultaneous quantitative noninvasive measurements of tissue oxyhemoglobin (OHb), deoxyhemoglobin (RHb), total hemoglobin concentration (THb), and tissue hemoglobin oxygen saturation (S(t)O(2)) are performed throughout LBNP application using broadband DOS. As progressively increasing amounts of LBNP are applied, HR increases, and MAP, SV, and Q decrease (p<0.001). OHb, S(t)O(2), and THb decrease (p<0.001) in correlation with progressive increases in LBNP, while tissue RHb remained relatively constant (p=0.378). The average fractional changes from baseline values in DOS OHb (fOHb) correlate closely with independently measured changes in SV (r(2)=0.95) and Q (r(2)=0.98) during LBNP. Quantitative noninvasive broadband DOS measurements of tissue hemoglobin parameters of peripheral perfusion are capable of detecting progressive reductions in central blood volume, and appear to be sensitive markers of early hypoperfusion associated with hemorrhage as simulated by LBNP.
authors.affiliation: University of California, Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612, USA. jangwl@uci.edu
authors.forename: Jangwoen
authors.initials: J
authors.lastname: Lee
authors.forename: Jae G
authors.initials: JG
authors.lastname: Kim
authors.forename: Sari
authors.initials: S
authors.lastname: Mahon
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Tromberg
authors.forename: Kathy L
authors.initials: KL
authors.lastname: Ryan
authors.forename: Victor A
authors.initials: VA
authors.lastname: Convertino
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Rickards
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: Matthew
authors.initials: M
authors.lastname: Brenner
mesh_terms: D000465:Algorithms; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis* / Q000378:metabolism*; D008150:Lower Body Negative Pressure / Q000379:methods; D008297:Male; D010100:Oxygen / Q000032:analysis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D010100:Oxygen