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脑死亡的无创和敏感的光学评估。

Noninvasive and sensitive optical assessment of brain death.

机构信息

Biomedical Engineering Institute, Chinese Academy of Medical Science and Peking Union Medical College, Tianjin, China.

State Key Lab Elect Thin Film & Integrated Device, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

J Biophotonics. 2019 Mar;12(3):e201800240. doi: 10.1002/jbio.201800240. Epub 2018 Dec 13.

Abstract

Brain death is an irreversible loss of all brain functions, and the assessment is crucial for organ supply for transplantation. The noninvasive, sensitive, universally available and timely ancillary method to assess brain death has not been established. Here, we attempted to explore a noninvasive way in brain death assessment. Eighteen brain-dead patients and 20 healthy subjects were measured by near-infrared spectroscopy (NIRS), with a multiple-phase protocol at varied fraction of inspired O (FIO ). We found that the concentration changes ratios of oxyhemoglobin to deoxyhemoglobin (Δ[HbO ]/Δ[Hb]) in the cerebral cortex of brain-dead patients were significantly higher than those of healthy subjects. And, the Δ[HbO ]/Δ[Hb] in low-to-high FIO phase was most sensitive to distinguish brain-dead patients from healthy subjects, with a recommended threshold ranged in 1.40~1.50. The innovative incorporation of NIRS and a varied FIO protocol was shown to be a noninvasive and reliable way in assessing brain death. This successful attempt of NIRS application is a help for fast and accurate evaluation of brain death, promptly offering quality-assured donor organs and indicate us a protocol-aided way to expand the use of NIRS.

摘要

脑死亡是大脑所有功能的不可逆转丧失,评估对于器官供移植至关重要。尚未建立非侵入性、敏感、普遍可用且及时的辅助方法来评估脑死亡。在这里,我们试图探索一种非侵入性的脑死亡评估方法。我们使用近红外光谱(NIRS)对 18 名脑死亡患者和 20 名健康受试者进行了测量,采用了多相方案,在不同的吸入氧气分数(FIO)下进行。我们发现脑死亡患者大脑皮层的氧合血红蛋白与脱氧血红蛋白浓度变化比(Δ[HbO]/Δ[Hb])明显高于健康受试者。并且,低至高 FIO 相的Δ[HbO]/Δ[Hb]对区分脑死亡患者和健康受试者最敏感,建议阈值范围在 1.40~1.50。NIRS 和变化的 FIO 方案的创新结合被证明是一种非侵入性和可靠的脑死亡评估方法。NIRS 应用的这一成功尝试有助于快速准确地评估脑死亡,及时提供质量保证的供体器官,并为我们提供了一种方案辅助的方法来扩大 NIRS 的使用。

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