跳出固有思维：一款适用于直升机紧急医疗服务的可穿戴近红外光谱监测仪。
Thinking Out of the (Big) Box: A Wearable Near-Infrared Spectroscopy Monitor for the Helicopter Emergency Medical Service.
机构信息
Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands; Helicopter Emergency Medical Service Lifeliner 1, Amsterdam University Medical Center, The Netherlands.
Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands; Helicopter Emergency Medical Service Lifeliner 1, Amsterdam University Medical Center, The Netherlands.
出版信息
Air Med J. 2020 Mar-Apr;39(2):120-123. doi: 10.1016/j.amj.2019.10.002. Epub 2019 Nov 6.
OBJECTIVE
In prehospital helicopter emergency medical service (HEMS) settings, the medical team has limited monitoring options, usually restricted to systemic variables. Regional tissue oxygenation (rO) can be assessed by near-infrared spectroscopy (NIRS), but clinical NIRS monitors are unpractical ("big boxes" and additional cables) in HEMS. As an alternative, we identified a wearable, athlete training NIRS device (Moxy; Idiag, Fehraltorf, Switzerland) and hypothesized that it would be applicable in our HEMS setting.
METHODS
This feasibility study was performed at the Dutch HEMS Lifeliner 1. The Moxy sensor was tested in-flight and on ground. We tested various anatomic measurement spots, and multiple conditions and interventions were imposed to track rO.
RESULTS
The rO measurements with the wearable Moxy NIRS device are both feasible and practical in an HEMS setting. Multiple conditions and interventions were tested successfully (eg, tourniquet placement [rO↓], muscle compression [rO↓], reperfusion [rO↑], oxygen administration [rO↑], hyperemia [rO↑], and venous congestion [rO↓]).
CONCLUSION
Our results suggest that rO measurements with the wearable Moxy NIRS device are both feasible and practical in HEMS, and Moxy allows the tracking of simulated pathophysiologic effects on rO. Future studies will have to verify our preliminary data and elucidate if and how wearable NIRS monitoring may support treatment in HEMS and improve patient outcome.
目的
在院前直升机紧急医疗服务（HEMS）环境中，医疗团队的监测选项有限，通常仅限于系统性变量。近红外光谱（NIRS）可用于评估局部组织氧合（rO），但临床 NIRS 监测仪在 HEMS 中不实用（“大盒子”和额外的电缆）。作为替代方案，我们确定了一种可穿戴的、运动员训练用 NIRS 设备（Moxy；Idiag，Fehraltorf，瑞士），并假设它适用于我们的 HEMS 环境。
方法
这项可行性研究在荷兰 HEMS Lifeliner 1 进行。在飞行中和地面上测试了 Moxy 传感器。我们测试了各种解剖测量点，并施加了多种条件和干预措施来跟踪 rO。
结果
可穿戴的 Moxy NIRS 设备的 rO 测量在 HEMS 环境中既可行又实用。成功测试了多种条件和干预措施（例如，止血带放置[rO↓]，肌肉压迫[rO↓]，再灌注[rO↑]，供氧[rO↑]，充血[rO↑]和静脉淤血[rO↓]）。
结论
我们的结果表明，可穿戴的 Moxy NIRS 设备的 rO 测量在 HEMS 中既可行又实用，并且 Moxy 允许跟踪 rO 上模拟的病理生理效应。未来的研究将不得不验证我们的初步数据，并阐明可穿戴 NIRS 监测是否以及如何能够支持 HEMS 中的治疗并改善患者预后。
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