Weigl Wojciech, Milej Daniel, Janusek Dariusz, Wojtkiewicz Stanisław, Sawosz Piotr, Kacprzak Michał, Gerega Anna, Maniewski Roman, Liebert Adam
Department of Surgical Sciences/Anaesthesiology and Intensive Care, Uppsala University, Akademiska Hospital, Uppsala, Sweden
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.
J Cereb Blood Flow Metab. 2016 Nov;36(11):1825-1843. doi: 10.1177/0271678X16667953. Epub 2016 Sep 7.
We present an overview of the wide range of potential applications of optical methods for monitoring traumatic brain injury. The MEDLINE database was electronically searched with the following search terms: "traumatic brain injury," "head injury," or "head trauma," and "optical methods," "NIRS," "near-infrared spectroscopy," "cerebral oxygenation," or "cerebral oximetry." Original reports concerning human subjects published from January 1980 to June 2015 in English were analyzed. Fifty-four studies met our inclusion criteria. Optical methods have been tested for detection of intracranial lesions, monitoring brain oxygenation, assessment of brain perfusion, and evaluation of cerebral autoregulation or intracellular metabolic processes in the brain. Some studies have also examined the applicability of optical methods during the recovery phase of traumatic brain injury . The limitations of currently available optical methods and promising directions of future development are described in this review. Considering the outstanding technical challenges, the limited number of patients studied, and the mixed results and opinions gathered from other reviews on this subject, we believe that optical methods must remain primarily research tools for the present. More studies are needed to gain confidence in the use of these techniques for neuromonitoring of traumatic brain injury patients.
我们概述了光学方法在监测创伤性脑损伤方面的广泛潜在应用。使用以下检索词对MEDLINE数据库进行电子检索:“创伤性脑损伤”、“头部损伤”或“头部创伤”,以及“光学方法”、“近红外光谱”、“近红外光谱法”、“脑氧合”或“脑血氧饱和度测定法”。分析了1980年1月至2015年6月以英文发表的关于人类受试者的原始报告。54项研究符合我们的纳入标准。光学方法已被用于检测颅内病变、监测脑氧合、评估脑灌注以及评估脑自动调节或脑内细胞内代谢过程。一些研究还考察了光学方法在创伤性脑损伤恢复阶段的适用性。本综述描述了当前可用光学方法的局限性以及未来发展的有前景方向。考虑到突出的技术挑战、所研究患者数量有限以及从关于该主题的其他综述中收集到的结果和观点不一,我们认为目前光学方法仍主要是研究工具。需要更多研究以增强对将这些技术用于创伤性脑损伤患者神经监测的信心。