Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
PLoS One. 2021 May 10;16(5):e0251271. doi: 10.1371/journal.pone.0251271. eCollection 2021.
Spinal cord ischemia leads to iatrogenic injury in multiple surgical fields, and the ability to immediately identify onset and anatomic origin of ischemia is critical to its management. Current clinical monitoring, however, does not directly measure spinal cord blood flow, resulting in poor sensitivity/specificity, delayed alerts, and delayed intervention. We have developed an epidural device employing diffuse correlation spectroscopy (DCS) to monitor spinal cord ischemia continuously at multiple positions. We investigate the ability of this device to localize spinal cord ischemia in a porcine model and validate DCS versus Laser Doppler Flowmetry (LDF). Specifically, we demonstrate continuous (>0.1Hz) spatially resolved (3 locations) monitoring of spinal cord blood flow in a purely ischemic model with an epidural DCS probe. Changes in blood flow measured by DCS and LDF were highly correlated (r = 0.83). Spinal cord blood flow measured by DCS caudal to aortic occlusion decreased 62%. This monitor demonstrated a sensitivity of 0.87 and specificity of 0.91 for detection of a 25% decrease in flow. This technology may enable early identification and critically important localization of spinal cord ischemia.
脊髓缺血可导致多个外科领域的医源性损伤，因此，能够立即识别缺血的发生和解剖起源对于其治疗至关重要。然而，目前的临床监测并不能直接测量脊髓血流量，导致其灵敏度/特异性差、报警延迟和干预延迟。我们开发了一种硬膜外设备，采用漫反射相关光谱（DCS）技术在多个位置连续监测脊髓缺血。我们研究了该设备在猪模型中定位脊髓缺血的能力，并验证了 DCS 与激光多普勒血流测量（LDF）的结果。具体来说，我们在单纯缺血模型中使用硬膜外 DCS 探头连续（>0.1Hz）、空间分辨（3 个位置）地监测脊髓血流。DCS 和 LDF 测量的血流变化高度相关（r = 0.83）。主动脉闭塞后 DCS 测量的脊髓血流在尾部下降了 62%。该监测器对检测 25%的血流减少具有 0.87 的灵敏度和 0.91 的特异性。该技术可能能够早期识别和关键定位脊髓缺血。
