Near infrared spectroscopy as possible non-invasive monitor of slow vasogenic ICP waves.
We aimed to study synchronisation between ICP and near infrared spectroscopy (NIRS) variables induced by vasogenic waves of ICP during an infusion study in hydrocephalic patients and after TBI. Nineteen patients presenting with hydrocephalus underwent a diagnostic intraventricular constant-flow infusion test. The original concept of the methodology, presented in the current paper, was derived from this material. Then the method was applied in 40 TBI patients, with results reported in an observational manner. During monitoring, NIRS deoxygenated and oxygenated haemoglobin (Hb, HbO(2)) were recorded simultaneously with ICP. Moving correlation coefficient (6 min) between Hb and HbO(2) was tested as a marker of the slow vasogenic waves of ICP.During infusion studies ICP increased from 10.7 (5.1) mmHg to a plateau of 18.9 (7.6) mmHg, which was associated with an increase in the power of slow ICP waves (p = 0.000017). Fluctuations of Hb and HbO(2) at baseline negatively correlated with each other, but switched to high positive values during periods of increased ICP slow-wave activity during infusion (p < 0.001). Similar behaviour was observed in TBI patients: baseline negative Hb/HbO(2) correlation changed to positive values during peaks of ICP of vasogenic nature.Correlating changes in Hb and HbO(2) may be of use as a method of non-invasive detection of vasogenic ICP waves.
University of Cambridge, Cambridge, UK.
Ruwan Alwis
RA
Weerakkody
Marek
M
Czosnyka
Christian
C
Zweifel
Gianluca
G
Castellani
Peter
P
Smielewski
Ken
K
Brady
John D
JD
Pickard
Zofia
Z
Czosnyka
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D019265:Spectroscopy, Near-Infrared; D013223:Statistics as Topic; D055815:Young Adult
D006454:Hemoglobins