Portable Diffuse Optical Sensors for Point-of-Care Monitoring in Prolonged Field Care
Abstract
Background: Standard hemodynamic monitoring such as blood pressure and pulse oximetry provide indirect estimates of organ perfusion in critical care settings. By contrast, the proposed diffuse correlation spectroscopy (DCS) and near infrared spectroscopy (NIRS) methods (based on the same light-tissue interaction principle as a pulse oximeter) allow continuous noninvasive monitoring of blood flow and tissue oxygen saturation. Multiple studies over two decades have shown comprehensive results for the use of the bio-optical sensors in surgical/trauma intensive care units during shock management as a prognostic tool and in guiding resuscitation. Objective: Here, we propose to integrate multiple clinical capabilities into a stand-alone, multifunction point-of-care medical device by combining the power of both DCS and NIRS approaches into development of a single diffuse optical device (DCS-NIRS). The project aims to develop a multifunction system that is aligned to the focus area of point-of-care imaging in prolonged field care and to demonstrate monitor of following physiological functions important in prolonged field care: (i) Cerebral and somatic oximetry monitoring (critical physiological parameters in various injuries including hypoxia and hemorrhage especially for en route care) (ii) Cerebral and somatic blood flow and blood volume monitoring (important physiological parameters in various injuries specifically for hemorrhage assessment and management) (iii) Cerebral edema monitoring (traumatic or hypoxic-ischemic brain injury) Other potential clinical applications that can benefit from proposed device and DCS-NIRS-derived physiological biomarkers include: (a) Local cerebral oximetry measurement (important for traumatic brain injury [TBI] and stroke victims) (b) Depth of anesthesia and sedation monitoring for ambulatory anesthesia (important for monitoring patients during field surgery, personalize and optimize the use of anesthetics) (c) Cognitive state assessment (quantitative brain function evaluation, assessment of cognitive function impairment for mild TBI; Warfighter’s stress and mental workload assessment; quantitative cognitive performance evaluation during training and deployment) (d) Heart rate and respiration rate (important for all types of injuries; can serve as physiological state and stress monitoring tools) (e) Early detection and monitoring of soft tissue injury that leads to pressure ulcers (important for injured Warfighters during periods of prolonged immobilization, such as medical evacuation and surgical procedures). Military and Civilian Benefits: Currently, some of these monitoring capabilities can only be conducted within hospital environments (such as local brain and body oximetry, brain edema monitoring, systemic and local hemorrhage evaluation and depth of anesthesia monitoring) and others are available only via dedicated, stand-alone devices (such as brain hematoma detection, heart rate and respiration rate). Combining multiple combat casualty care capabilities in a single portable device has the potential to greatly upgrade diagnostic accuracy and guide better triage and treatments in austere environments. Multifunction clinical capabilities together with low size, weight and long operation are key features of medical devices intended for field conditions. The proposed device will comply with prolonged field care design requirements and will significantly improve the medical management of injuries in harsh environments, common both to battlefield and to emergency response in rural/remote medicine. It will save lives by enabling rapid screening and triage of TBI and hemorrhagic shock patients on the accident site, and assisting medical decisions during prolonged field care and or during transportation under combat and similarly difficult emergency environments.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010899
Entities
People
- Kurtuluş İzzetoǧlu
Organizations
- Drexel University
- United States Army