BACKGROUND: Traumatic brain injury (TBI) is a significant cause of death and severe disability from trauma. Pre-hospital care of patients with TBI may be aided by non-invasive monitoring of cerebral tissue oxygenation. This pilot observational study was designed to assess if cerebral tissue oximetry using near-infrared spectroscopy (NIRS) is feasible in the pre-hospital and transport environment. METHODS: After ethics committee review, we undertook a feasibility trial in healthy volunteers, transported by road ambulance or helicopter, to assess if monitoring signals could be obtained in the outside environment and during patient transport. RESULTS: A total of 33 road ambulance transports and 32 helicopter transports were undertaken. For monitoring commenced outdoors, 33 of 66 probes applied (50%) provided adequate monitoring signal. For road transports, 33 out of 33 transports (100%) resulted in successful bilateral monitoring for more than 70% of the sampling period. For helicopter transports, four transports were cut short by battery failure during the mission and 24 of 28 transports (85.7%) resulted in successful bilateral monitoring for more than 70% of the sampling period. While patient and transport platform movement did not impact on monitoring signals, exposure to ambient light provided a challenge in obtaining monitoring signals that is nevertheless manageable with increased probe shielding. CONCLUSIONS: NIRS monitoring is feasible in the pre-hospital environment, opening up the possibility for further research of the role of this modality in this setting.
BACKGROUND:Traumatic brain injury (TBI) is a significant cause of death and severe disability from trauma. Pre-hospital care of patients with TBI may be aided by non-invasive monitoring of cerebral tissue oxygenation. This pilot observational study was designed to assess if cerebral tissue oximetry using near-infrared spectroscopy (NIRS) is feasible in the pre-hospital and transport environment. METHODS: After ethics committee review, we undertook a feasibility trial in healthy volunteers, transported by road ambulance or helicopter, to assess if monitoring signals could be obtained in the outside environment and during patient transport. RESULTS: A total of 33 road ambulance transports and 32 helicopter transports were undertaken. For monitoring commenced outdoors, 33 of 66 probes applied (50%) provided adequate monitoring signal. For road transports, 33 out of 33 transports (100%) resulted in successful bilateral monitoring for more than 70% of the sampling period. For helicopter transports, four transports were cut short by battery failure during the mission and 24 of 28 transports (85.7%) resulted in successful bilateral monitoring for more than 70% of the sampling period. While patient and transport platform movement did not impact on monitoring signals, exposure to ambient light provided a challenge in obtaining monitoring signals that is nevertheless manageable with increased probe shielding. CONCLUSIONS: NIRS monitoring is feasible in the pre-hospital environment, opening up the possibility for further research of the role of this modality in this setting.
Authors: David J Davies; Zhangjie Su; Michael T Clancy; Samuel J E Lucas; Hamid Dehghani; Ann Logan; Antonio Belli Journal: J Neurotrauma Date: 2015-04-17 Impact factor: 5.269
Authors: A P Kontos; T J Huppert; N H Beluk; R J Elbin; L C Henry; J French; S M Dakan; M W Collins Journal: Brain Imaging Behav Date: 2014-12 Impact factor: 3.978
Authors: Mario Forcione; Mario Ganau; Lara Prisco; Antonio Maria Chiarelli; Andrea Bellelli; Antonio Belli; David James Davies Journal: Int J Mol Sci Date: 2021-01-23 Impact factor: 5.923
Authors: Andrew Weatherall; Alan Garner; Nigel Lovell; Stephen Redmond; Anna Lee; Justin Skowno; Jonathan Egan Journal: Scand J Trauma Resusc Emerg Med Date: 2014-10-03 Impact factor: 2.953