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

Research output: Contribution to journalReview articlepeer-review

Authors

  • Mario Forcione
  • Mario Ganau
  • Lara Prisco
  • Antonio Maria Chiarelli
  • Andrea Bellelli

External organisations

  • Oxford University Hospitals NHS Foundation Trust
  • G. d'Annunzio University of Chieti-Pescara
  • University of Rome La Sapienza

Abstract

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.

Details

Original languageEnglish
Article number1122
Number of pages26
JournalInternational Journal of Molecular Sciences
Volume22
Issue number3
Publication statusPublished - 23 Jan 2021

Keywords

  • Biosignature, Computerized tomography, Contrast‐enhanced near‐infrared spectroscopy, Diffuse optical tomography, Microdialysis, Multimodal neuromonitoring, Near‐infrared spectroscopy, Tissue partial oxygen pressure, Tissue respiration, Traumatic brain injury