Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy
The brain tissue partial oxygen pressure (PbtO<sub>2</sub>) and near-infrared spectroscopy (NIRS) neuromonitoring are frequently compared in the management of acute moderate and severe traumatic brain injury patients; however, the relationship between their respective output parameters f...
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| Format: | Article |
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MDPI AG
2021-01-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/22/3/1122 |
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| author | Mario Forcione Mario Ganau Lara Prisco Antonio Maria Chiarelli Andrea Bellelli Antonio Belli David James Davies |
| author_facet | Mario Forcione Mario Ganau Lara Prisco Antonio Maria Chiarelli Andrea Bellelli Antonio Belli David James Davies |
| author_sort | Mario Forcione |
| collection | DOAJ |
| description | The brain tissue partial oxygen pressure (PbtO<sub>2</sub>) and near-infrared spectroscopy (NIRS) neuromonitoring are frequently compared in the management of acute moderate and severe traumatic brain injury patients; however, the relationship between their respective output parameters flows from the complex pathogenesis of tissue respiration after brain trauma. NIRS neuromonitoring overcomes certain limitations related to the heterogeneity of the pathology across the brain that cannot be adequately addressed by local-sample invasive neuromonitoring (e.g., PbtO<sub>2</sub> neuromonitoring, microdialysis), and it allows clinicians to assess parameters that cannot otherwise be scanned. The anatomical co-registration of an NIRS signal with axial imaging (e.g., computerized tomography scan) enhances the optical signal, which can be changed by the anatomy of the lesions and the significance of the radiological assessment. These arguments led us to conclude that rather than aiming to substitute PbtO<sub>2</sub> with tissue saturation, multiple types of NIRS should be included via multimodal systemic- and neuro-monitoring, whose values then are incorporated into biosignatures linked to patient status and prognosis. Discussion on the abnormalities in tissue respiration due to brain trauma and how they affect the PbtO<sub>2</sub> and NIRS neuromonitoring is given. |
| first_indexed | 2024-03-09T03:51:17Z |
| format | Article |
| id | doaj.art-365b1fdf905f4825a0a8de94a45f36af |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T03:51:17Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-365b1fdf905f4825a0a8de94a45f36af2023-12-03T14:26:37ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672021-01-01223112210.3390/ijms22031122Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring StrategyMario Forcione0Mario Ganau1Lara Prisco2Antonio Maria Chiarelli3Andrea Bellelli4Antonio Belli5David James Davies6Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartment of Clinical Neurosciences, Oxford University Hospitals NHS Foundation Trust, Headly Way, Oxford OX3 9DU, UKDepartment of Clinical Neurosciences, Oxford University Hospitals NHS Foundation Trust, Headly Way, Oxford OX3 9DU, UKImaging and Clinical Sciences, Department of Neuroscience, University G. D’Annunzio of Chieti-Pescara, Institute for Advanced Biomedical Technologies, Via Luigi Polacchi 13, 66100 Chieti, ItalyDepartment of Biochemical Sciences “A. Rossi Fanelli”, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Viale Regina Elena 332, 00185 Rome, ItalyNeuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKNeuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKThe brain tissue partial oxygen pressure (PbtO<sub>2</sub>) and near-infrared spectroscopy (NIRS) neuromonitoring are frequently compared in the management of acute moderate and severe traumatic brain injury patients; however, the relationship between their respective output parameters flows from the complex pathogenesis of tissue respiration after brain trauma. NIRS neuromonitoring overcomes certain limitations related to the heterogeneity of the pathology across the brain that cannot be adequately addressed by local-sample invasive neuromonitoring (e.g., PbtO<sub>2</sub> neuromonitoring, microdialysis), and it allows clinicians to assess parameters that cannot otherwise be scanned. The anatomical co-registration of an NIRS signal with axial imaging (e.g., computerized tomography scan) enhances the optical signal, which can be changed by the anatomy of the lesions and the significance of the radiological assessment. These arguments led us to conclude that rather than aiming to substitute PbtO<sub>2</sub> with tissue saturation, multiple types of NIRS should be included via multimodal systemic- and neuro-monitoring, whose values then are incorporated into biosignatures linked to patient status and prognosis. Discussion on the abnormalities in tissue respiration due to brain trauma and how they affect the PbtO<sub>2</sub> and NIRS neuromonitoring is given.https://www.mdpi.com/1422-0067/22/3/1122tissue partial oxygen pressurenear-infrared spectroscopymultimodal neuromonitoringbiosignaturetraumatic brain injurytissue respiration |
| spellingShingle | Mario Forcione Mario Ganau Lara Prisco Antonio Maria Chiarelli Andrea Bellelli Antonio Belli David James Davies Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy International Journal of Molecular Sciences tissue partial oxygen pressure near-infrared spectroscopy multimodal neuromonitoring biosignature traumatic brain injury tissue respiration |
| title | Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy |
| title_full | Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy |
| title_fullStr | Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy |
| title_full_unstemmed | Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy |
| title_short | Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy |
| title_sort | mismatch between tissue partial oxygen pressure and near infrared spectroscopy neuromonitoring of tissue respiration in acute brain trauma the rationale for implementing a multimodal monitoring strategy |
| topic | tissue partial oxygen pressure near-infrared spectroscopy multimodal neuromonitoring biosignature traumatic brain injury tissue respiration |
| url | https://www.mdpi.com/1422-0067/22/3/1122 |
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