Division of Neuronic Engineering, Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 52, Huddinge, Sweden.
Acta Neurochir (Wien). 2021 Sep;163(9):2603-2614. doi: 10.1007/s00701-021-04938-5. Epub 2021 Jul 22.
Hyperosmotic therapy is a mainstay treatment for cerebral edema. Although often effective, its disadvantages include mainly acting on the normal brain region with limited effectiveness in eliminating excess fluid in the edema region. This study investigates how to configure our previously proposed novel electroosmosis based edema treatment as a complement to hyperosmotic therapy.
Three electrode configurations are designed to drive the excess fluid out of the edema region, including 2-electrode, 3-electrode, and 5-electrode designs. The focality and directionality of the induced electroosmotic flow (EOF) are then investigated using the same patient-specific head model with localized edema.
The 5-electrode design shows improved EOF focality with reduced effect on the normal brain region than the other two designs. Importantly, this design also achieves better directionality driving excess edema tissue fluid to a larger region of surrounding normal brain where hyperosmotic therapy functions better. Thus, the 5-electrode design is suggested to treat edema more efficiently via a synergic effect: the excess fluid is first driven out from the edema to surrounding normal brain via EOF, where it can then be treated with hyperosmotic therapy. Meanwhile, the 5-electrode design drives 2.22 mL excess fluid from the edema region in an hour comparable to the other designs, indicating a similar efficiency of EOF.
The results show that the promise of our previously proposed novel electroosmosis based edema treatment can be designed to achieve better focality and directionality towards a complement to hyperosmotic therapy.
高渗疗法是治疗脑水肿的主要方法。尽管它通常有效,但也有缺点,主要是作用于正常脑区,对消除水肿区多余液体的效果有限。本研究探讨如何将我们之前提出的新型基于电渗的水肿治疗方法作为高渗治疗的补充。
设计了三种电极配置,以将多余的液体从水肿区排出,包括 2 电极、3 电极和 5 电极设计。然后使用具有局部水肿的相同患者特定头部模型研究了诱导的电渗流(EOF)的聚焦性和方向性。
5 电极设计显示出改善的 EOF 聚焦性,对正常脑区的影响小于其他两种设计。重要的是,这种设计还实现了更好的方向性,将多余的水肿组织液驱动到更大的周围正常脑组织区域,高渗治疗在该区域效果更好。因此,建议通过协同作用来更有效地治疗水肿:首先通过电渗流将多余的液体从水肿区排出到周围正常脑区,然后可以用高渗治疗进行治疗。同时,5 电极设计在一小时内从水肿区驱动 2.22 毫升多余的液体,与其他设计相当,表明 EOF 的效率相似。
结果表明,我们之前提出的新型基于电渗的水肿治疗方法的潜力可以设计为更好地聚焦和定向,以补充高渗治疗。