IEEE Trans Biomed Eng. 2021 Aug;68(8):2582-2591. doi: 10.1109/TBME.2021.3069133. Epub 2021 Jul 16.
An optical imaging system is proposed for quantitatively assessing jugular venous response to altered central venous pressure.
The proposed system assesses sub-surface optical absorption changes from jugular venous waveforms with a spatial calibration procedure to normalize incident tissue illumination. Widefield frames of the right lateral neck were captured and calibrated using a novel flexible surface calibration method. A hemodynamic optical model was derived to quantify jugular venous optical attenuation (JVA) signals, and generate a spatial jugular venous pulsatility map. JVA was assessed in three cardiovascular protocols that altered central venous pressure: acute central hypovolemia (lower body negative pressure), venous congestion (head-down tilt), and impaired cardiac filling (Valsalva maneuver).
JVA waveforms exhibited biphasic wave properties consistent with jugular venous pulse dynamics when time-aligned with an electrocardiogram. JVA correlated strongly (median, interquartile range) with invasive central venous pressure during graded central hypovolemia (r = 0.85, [0.72, 0.95]), graded venous congestion (r = 0.94, [0.84, 0.99]), and impaired cardiac filling (r = 0.94, [0.85, 0.99]). Reduced JVA during graded acute hypovolemia was strongly correlated with reductions in stroke volume (SV) (r = 0.85, [0.76, 0.92]) from baseline (SV: 79 ± 15 mL, JVA: 0.56 ± 0.10 a.u.) to -40 mmHg suction (SV: 59 ± 18 mL, JVA: 0.47 ± 0.05 a.u.; p 0.01).
The proposed non-contact optical imaging system demonstrated jugular venous dynamics consistent with invasive central venous monitoring during three protocols that altered central venous pressure.
This system provides non-invasive monitoring of pressure-induced jugular venous dynamics in clinically relevant conditions where catheterization is traditionally required, enabling monitoring in non-surgical environments.
提出了一种光学成像系统，用于定量评估颈静脉对中心静脉压变化的反应。
所提出的系统通过空间校准程序评估颈静脉波形的亚表面光吸收变化，以对入射组织照明进行归一化。捕获并使用新颖的柔性表面校准方法校准右侧颈部的广角帧。推导了一个血液动力学光学模型，以量化颈静脉光衰减（JVA）信号，并生成空间颈静脉搏动图。在改变中心静脉压的三个心血管方案中评估了 JVA：急性中心低血容量（下体负压）、静脉充血（头低位倾斜）和心脏充盈受损（瓦尔萨尔手法）。
当与心电图时间对齐时，JVA 波形表现出与颈静脉脉搏动力学一致的双相波特性。在逐渐降低中心低血容量（r = 0.85，[0.72，0.95]）、逐渐增加静脉充血（r = 0.94，[0.84，0.99]）和心脏充盈受损（r = 0.94，[0.85，0.99]）期间，JVA 与侵入性中心静脉压强烈相关。在逐渐降低急性低血容量期间，JVA 的降低与从基线（SV：79 ± 15 毫升，JVA：0.56 ± 0.10 个单位）到-40mmHg 抽吸（SV：59 ± 18 毫升，JVA：0.47 ± 0.05 个单位）的 SV 减少呈强相关（p<0.01）。
所提出的非接触式光学成像系统在改变中心静脉压的三个方案中展示了与侵入性中心静脉监测一致的颈静脉动力学。
该系统提供了在临床上需要导管插入术的情况下传统上需要的压力诱导颈静脉动力学的非侵入性监测，从而能够在非手术环境中进行监测。
