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一种新型多参数脑探针评估在猪模型中同时测量脑组织氧合、脑血流、颅内压和脑温。

Evaluation of a New Multiparameter Brain Probe for Simultaneous Measurement of Brain Tissue Oxygenation, Cerebral Blood Flow, Intracranial Pressure, and Brain Temperature in a Porcine Model.

机构信息

Institute for Neurosurgical Pathophysiology, University Medical Center of the Johannes Gutenberg-University, Langenbeckstr. 1, 55131, Mainz, Germany.

Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Neurocrit Care. 2018 Oct;29(2):291-301. doi: 10.1007/s12028-018-0541-9.

Abstract

BACKGROUND

A novel multiparameter brain sensor (MPBS) allows the simultaneous measurement of brain tissue oxygenation (ptiO), cerebral blood flow (CBF), intracranial pressure (ICP), and brain temperature with a single catheter. This laboratory investigation evaluates the MPBS in an animal model in relation to established reference probes.

METHODS

The study group consisted of 17 juvenile male pigs. Four MPBS and four reference probes were implanted per pig and compared simultaneously. The measured parameters were challenged by standardized provocations such as hyperoxia, dobutamine, and norepinephrine application, hypercapnia and hypoxia in combination with and without a controlled cortical impact (CCI) injury. Mean values over 2 min were collected for predefined time points and were analyzed using Bland-Altman plots.

RESULTS

The protocol was successfully conducted in 15 pigs of which seven received CCI. ICP and ptiO were significantly influenced by the provocations. Subtraction of MPBS from reference values revealed a mean difference (limits of agreement) of 3.7 (- 20.5 to 27.9) mm Hg, - 2.9 (- 7.9 to 2.1) mm Hg, and 5.1 (- 134.7 to 145.0) % for ptiO, ICP, and relative CBF, respectively.

CONCLUSIONS

The MPBS is a promising measurement tool for multiparameter neuromonitoring. The conducted study demonstrates the in vivo functionality of the probe. Comparison with standard probes revealed a deviation which is mostly analogous to other multiparameter devices. However, further evaluation of the device is necessary before it can reliably be used for clinical decision making.

摘要

背景

一种新型的多参数脑传感器(MPBS)可通过单个导管同时测量脑组织氧合(ptiO)、脑血流(CBF)、颅内压(ICP)和脑温。本实验室研究通过与已建立的参考探头比较,评估了动物模型中的 MPBS。

方法

研究组包括 17 头雄性幼猪。每头猪植入四个 MPBS 和四个参考探头,并同时进行比较。通过标准化刺激(如过度供氧、多巴酚丁胺和去甲肾上腺素应用、高碳酸血症和缺氧)来挑战所测量的参数,并结合和不结合受控皮质撞击(CCI)损伤。在预设时间点收集 2 分钟的平均值,并使用 Bland-Altman 图进行分析。

结果

15 头猪成功完成了方案,其中 7 头接受了 CCI。ICP 和 ptiO 受到了刺激的显著影响。MPBS 与参考值的差值显示出平均差异(一致性界限)为 3.7(-20.5 至 27.9)mmHg、-2.9(-7.9 至 2.1)mmHg 和 5.1(-134.7 至 145.0)%,分别用于 ptiO、ICP 和相对 CBF。

结论

MPBS 是一种有前途的多参数神经监测测量工具。进行的研究证明了探头的体内功能。与标准探头的比较显示出的偏差与其他多参数设备基本相似。然而,在该设备能够可靠地用于临床决策之前,还需要进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a803/6208836/9f25e364f7c5/12028_2018_541_Fig1_HTML.jpg

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