Frontiers of Optoelectronics, 2010, 3 (2): 153, 网络出版: 2012-09-20  

Optical monitoring of tissue viability parameters in vivo: from experimental animals to clinical applications

Optical monitoring of tissue viability parameters in vivo: from experimental animals to clinical applications
作者单位
1 Mina and Everard Goodman Faculty of Life Sciences, Gonda Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
2 CritiSense Ltd., Giv'at Shmu'el 54101, Israel
摘要
Abstract
Optical monitoring of tissue physiological and biochemical parameters in real-time is a new approach and a powerful tool for better clinical diagnosis and treatment. Most of the devices available for monitoring patients in critical conditions provide information on body respiratory and hemodynamic functions. Currently, monitoring of patients at the cellular and tissue level is very rare. Realtime monitoring of mitochondrial nicotinamide adenine dinucleotide (NADH) as an indicator of intra-cellular oxygen levels started 50 years ago. Mitochondrial dysfunction was recognized as a key element in the pathogenesis of various illnesses. We developed the “CritiView” — a revolutionary patient monitoring system providing real time data on mitochondrial function as well as microcirculatory blood flow, hemoglobin oxygenation as well as tissue reflectance. We hypothesize that under the development of body O2 insufficiency the well known blood flow redistribution mechanism will protect the most vital organs (brain and heart) by increasing blood flow while the less vital organs (gastrointestinal (GI) tract or urogenital system) will become hypoperfused and O2 delivery will diminish. Therefore, the less vital organs will be the initial responders to O2 imbalances and the last to recover after the end of resuscitation. The urethral wall represents a lessvital organ in the body and may be very sensitive to the development of emergency situations in patients. It is assumed that the beginning of deterioration processes (i.e., internal bleeding) as well as resuscitation end-points in critically ill patients will be detected. In this paper, we review the theoretical, technological, experimental and preliminary clinical results accumulated using the “CritiView”. Preliminary clinical studies suggest that our monitoring approach is practical in collecting data from the urethral wall in critical care medicine. Using CritiView in critical care medicine may shed new light on body O2 balance and the development of body emergency metabolic state.
参考文献

[1] Marik P E, Baram M. Noninvasive hemodynamic monitoring in the intensive care unit. Critical Care Clinics, 2007, 23(3): 383-400

[2] Ospina-Tascón G A, Cordioli R L, Vincent J L. What type of monitoring has been shown to improve outcomes in acutely ill patients Intensive Care Medicine, 2008, 34(5): 800-820

[3] Creteur J, Carollo T, Soldati G, Buchele G, De Backer D, Vincent J L. The prognostic value of muscle StO2 in septic patients. Intensive Care Medicine, 2007, 33(9): 1549-1556

[4] Shephard A P, Oberg P A. History of Laser-Doppler Blood Flowmeter: Laser-Doppler Blood Flowmeter. Boston: Kluwer Academic, 1990

[5] Batista J, Wagner J, Azadzoi K, Krane R, Siroky M. Direct measurement of blood flow in the human bladder. Journal of Urology, 1996, 155(2): 630-633

[6] Rampil I J, Litt L, Mayevsky A. Correlated, simultaneous, multiplewavelength optical monitoring in vivo of localized cerebrocortical NADH and brain microvessel hemoglobin oxygen saturation. Journal of Clinical Monitoring, 1992, 8(3): 216-225

[7] Mayevsky A, Crowe W, Mela L. The interrelation between brain oxidative metabolism and extracellular potassium in the unanesthetized gerbil. Neurological Research, 1980, 1(3): 213-225

[8] Lübbers D W. Optical sensors for clinical monitoring. Acta Anaesthesiologica Scandinavica Supplementum, 1995, 39(104): 37-54

[9] Scheffler I E. A century of mitochondrial research: achievements and perspectives. Mitochondrion, 2001, 1(1): 3-31

[10] Dóra E, Kovách A G B. Effect of topically administered epinephrine, norepinephrine, and acetylcholine on cerebrocortical circulation and the NAD/NADH redox state. Journal of Cerebral Blood Flow and Metabolism, 1983, 3(2): 161-169

[11] LaManna J C, Sylvia A L, Martel D, Rosenthal M. Fluorometric monitoring of the effects of adrenergic agents on oxidative metabolism in intact cerebral cortex. Neuropharmacology, 1976, 15(1): 17-24

[12] Chance B, Cohen P, Jobsis F, Schoener B. Intracellular oxidationreduction states in vivo. Science, 1962, 137 (3529): 499-508

[13] Zurovsky Y, Sonn J. Fiber optic surface fluorometry-reflectometry technique in the renal physiology of rats. Journal of Basic and Clinical Physiology and Pharmacology, 1992, 3(4): 343-358

[14] McCuskey R. The hepatic microvascular system. In: Arias I, Boyer J, Fausta N, Jakoby W, Schachter D, Shafritz D, eds. The Liver: Biology and Pharmacology. New York: Raven Press Ltd., 1994, 1089-1106

[15] Mayevsky A, Nakache R, Luger-Hamer M, Amran D, Sonn J. Assessment of transplanted kidney vitality by a multiparametric monitoring system. Transplantation Proceedings, 2001, 33(6): 2933-2934

[16] Rothe C F, Maass-Moreno R. Hepatic venular resistance responses to norepinephrine, isoproterenol, adenosine, histamine, and ACh in rabbits. American Journal of Physiology, 1998, 274(3): H777-H785

[17] Wheatley AM, Almond N E. Effect of hepatic nerve stimulation and norepinephrine on the laser Doppler flux signal from the surface of the perfused rat liver. International Journal of Microcirculation Clinical and Experimental, 1997, 17(1): 48-54

[18] Kraut A, Barbiro-Michaely E, Mayevsky A. Differential effects of norepinephrine on brain and other less vital organs detected by a multisite multiparametric monitoring system. Medical Science Monitor, 2004, 10(7): BR215-BR220

[19] Waltemath C L. Oxygen, uptake, transport, and tissue utilization. Anesthesia and Analgesia, 1970, 49(1): 184-203

[20] Chance B, Oshino N, Sugano T, Mayevsky A. Basic principles of tissue oxygen determination from mitochondrial signals. In: Bicher H I, Bruley D F, eds. Oxygen Transport to Tissue. Instrumentation, Methods, and Physiology. New York: Plenum Publishing Corporation, 1973, 277-292

[21] Chance B, Williams G R. Respiratory enzymes in oxidative phosphorylation. I. Kinetics of oxygen utilization. Journal of Biological Chemistry, 1955, 217(1): 383-393

[22] Nicholls D G, Budd S L. Mitochondria and neuronal survival. Physiological Reviews, 2000, 80(1): 315-360

[23] Mayevsky A, Barbiro-Michaely E, Kutai-Asis H, Deutsch A, Jaronkin A. Brain physiological state evaluated by real time multiparametric tissue spectroscopy in vivo. Proceedings of SPIE, 2004, 5326: 98-105

[24] Mayevsky A, Meilin S, Rogatsky G G, Zarchin N, Thom S R. Multiparametric monitoring of the awake brain exposed to carbon monoxide. Journal of Applied Physiology, 1995, 78(3): 1188-1196

[25] Mayevsky A. Brain NADH redox state monitored in vivo by fiber optic surface fluorometry. Brain Research, 1984, 319(1): 49-68

[26] Mayevsky A, Weiss H R. Cerebral blood flow and oxygen consumption in cortical spreading depression. Journal of Cerebral Blood Flow and Metabolism, 1991, 11(5): 829-836

[27] Mayevsky A, Flamm E S, Pennie W, Chance B. A fiber optic based multiprobe system for intraoperative monitoring of brain functions. Proceedings of SPIE, 1991, 1431: 303-313

[28] Mayevsky A, Frank K, Muck M, Nioka S, Kessler M, Chance B. Multiparametric evaluation of brain functions in the Mongolian gerbil in vivo. Journal of Basic and Clinical Physiology and Pharmacology, 1992, 3(4): 323-342

[29] Mayevsky A, Frank K H, Nioka S, Kessler M, Chance B. Oxygen supply and brain function in vivo: a multiparametric monitoring approach in the mongolian gerbil. In: Piiper J, Goldstick T K, Meyer M, eds. Oxygen Transport to Tissue XII. New York: Plenum Press, 1990, 303-313

[30] Deutsch A, Pevzner E, Jaronkin A, Mayevsky A. Real time evaluation of tissue vitality by monitoring of microcircultory blood flow, HbO2 and mitochondrial NADH redox state. Proceedings of SPIE, 2004, 5317: 116-127

[31] Pevzner E, Deutsch A, Manor T, Dekel N, Etziony R, Derzy I, Razon N, Mayevsky A. Real-time multiparametric spectroscopy as a practical tool for evaluation of tissue vitality in vivo. Proceedings of SPIE, 2003, 4958: 171-182

[32] Mayevsky A, Chance B. Intracellular oxidation-reduction state measured in situ by a multichannel fiber-optic surface fluorometer. Science, 1982, 217(4559): 537-540

[33] Stern M D. In vivo evaluation of microcirculation by coherent light scattering. Nature, 1975, 254(5495): 56-58

[34] Bonner R, Nossal R. Model for laser Doppler measurements of blood flow in tissue. Applied Optics, 1981, 20(12): 2097-2107

[35] Mayevsky A, Manor T, Pevzner E, Deutsch A, Etziony R, Dekel N, Jaronkin A. Tissue spectroscope: a novel in vivo approach to real time monitoring of tissue vitality. Journal of Biomedical Optics, 2004, 9(5): 1028-1045

[36] Mayevsky A, Zarchin N, Friedli C M. Factors affecting the oxygen balance in the awake cerebral cortex exposed to spreading depression. Brain Research, 1982, 236(1): 93-105

[37] Mayevsky A, Rogatsky G G. Mitochondrial function in vivo evaluated by NADH fluorescence: from animal models to human studies. American Journal of Physiology: Cell Physiology, 2007, 292(2): C615-C640

Avraham MAYEVSKY, Efrat BARBIRO-MICHAELY. Optical monitoring of tissue viability parameters in vivo: from experimental animals to clinical applications[J]. Frontiers of Optoelectronics, 2010, 3(2): 153. Avraham MAYEVSKY, Efrat BARBIRO-MICHAELY. Optical monitoring of tissue viability parameters in vivo: from experimental animals to clinical applications[J]. Frontiers of Optoelectronics, 2010, 3(2): 153.

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