title: Feasibility of cerebral near-infrared spectroscopy monitoring in the pre-hospital environment.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is a significant cause of death and severe disability from trauma. Pre-hospital care of patients with TBI may be aided by non-invasive monitoring of cerebral tissue oxygenation. This pilot observational study was designed to assess if cerebral tissue oximetry using near-infrared spectroscopy (NIRS) is feasible in the pre-hospital and transport environment.
  
  
  METHODS
  After ethics committee review, we undertook a feasibility trial in healthy volunteers, transported by road ambulance or helicopter, to assess if monitoring signals could be obtained in the outside environment and during patient transport.
  
  
  RESULTS
  A total of 33 road ambulance transports and 32 helicopter transports were undertaken. For monitoring commenced outdoors, 33 of 66 probes applied (50%) provided adequate monitoring signal. For road transports, 33 out of 33 transports (100%) resulted in successful bilateral monitoring for more than 70% of the sampling period. For helicopter transports, four transports were cut short by battery failure during the mission and 24 of 28 transports (85.7%) resulted in successful bilateral monitoring for more than 70% of the sampling period. While patient and transport platform movement did not impact on monitoring signals, exposure to ambient light provided a challenge in obtaining monitoring signals that is nevertheless manageable with increased probe shielding.
  
  
  CONCLUSIONS
  NIRS monitoring is feasible in the pre-hospital environment, opening up the possibility for further research of the role of this modality in this setting.
authors.affiliation: CareFlight, Sydney, NSW, Australia. andrew.weatherall@careflight.org
authors.forename: A
authors.initials: A
authors.lastname: Weatherall
authors.forename: J
authors.initials: J
authors.lastname: Skowno
authors.forename: A
authors.initials: A
authors.lastname: Lansdown
authors.forename: T
authors.initials: T
authors.lastname: Lupton
authors.forename: A
authors.initials: A
authors.lastname: Garner
mesh_terms: D000293:Adolescent; D000328:Adult; D017732:Air Ambulances; D000552:Ambulances; D001930:Brain Injuries / Q000503:physiopathology* / Q000628:therapy*; D004632:Emergency Medical Services / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D009068:Movement; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood; D010865:Pilot Projects; D015203:Reproducibility of Results; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D014187:Transportation of Patients; D014732:Vibration; D055815:Young Adult
chemical_list: D010100:Oxygen