Evaluation of a novel wireless near-infrared spectroscopy (NIRS) device in the detection of tourniquet induced ischaemia

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES BMJ Innovations Pub Date : 2022-01-01 DOI:10.1136/bmjinnov-2021-000752

M. Gimzewska, M. Berthelot, P. Sarai, L. Geoghegan, S. Onida, J. Shalhoub, P. Strutton, A. Davies

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Abstract

© Author(s) (or their employer(s)) 2022. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Acute limb ischaemia is a vascular emergency threatening both life and limb, with estimated mortality rates of 9%–22%, and 30day extremity amputation rates of 10%–30%. 3 Timely identification of the acutely ischaemic limb is pivotal. Conventional methods of assessing limb ischaemia rely on repeated clinical examination, serial assessment of Doppler signals and imaging technology such as duplex ultrasound, digital subtraction angiography, CT angiography and MR angiography. While able to assess arterial compromise, these technologies are limited as they provide data for only a single time point, and imaging modalities are high in cost and low in portability. The ability to noninvasively and continually monitor for limb ischaemia could enable identification of compromised tissue earlier, prompting faster revascularisation and reducing complications associated with prolonged ischaemia. A growing interest in the role of the microcirculation in tissue perfusion has led to the use of nearinfrared spectroscopy (NIRS) devices in the evaluation of limb ischaemia. 6 NIRS is a noninvasive spectroscopy method of obtaining regional tissue oxygen saturation (StO 2 ), using light wavelengths in the red and nearred range of the spectrogram. NIRSbased devices can reliably identify the ratio of oxygenated haemoglobin (HbO 2 ) and deoxyhaemoglobin (HHb) present in tissue, and as such are able to determine oxygen desaturation associated with limb ischaemia. 8 A number of commercial devices are available for clinical use. Some current limitations around using existing NIRS devices are cost and bulk around the patient bedspace. As such, they are rarely used outside the operating theatre and intensive care unit settings, where patients are relatively immobile and low nurse:patient ratios make the management of multiple wired devices in the bed space feasible for staff. The aims of this prospective study were: 1. To evaluate the feasibility of using a novel, wireless NIRS device in detecting tissue StO 2 in a tourniquetinduced model of limb ischaemia in healthy volunteers. Summary box

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一种新型无线近红外光谱(NIRS)装置在止血带致缺血检测中的评价

©作者(或其雇主)2022。禁止商业重用。请参阅权利和权限。英国医学杂志出版。急性肢体缺血是一种危及生命和肢体的血管急症，估计死亡率为9%-22%，30天截肢率为10%-30%。及时识别急性肢体缺血是至关重要的。肢体缺血的常规评估方法依赖于反复的临床检查、多普勒信号的连续评估以及双相超声、数字减影血管造影、CT血管造影和MR血管造影等成像技术。虽然能够评估动脉损伤，但这些技术的局限性在于它们只能提供单一时间点的数据，而且成像模式成本高，便携性低。无创和持续监测肢体缺血的能力可以更早地识别受损组织，促进更快的血运重建，减少与长期缺血相关的并发症。随着人们对微循环在组织灌注中的作用越来越感兴趣，近红外光谱(NIRS)设备被用于肢体缺血的评估。近红外光谱(NIRS)是一种获取区域组织氧饱和度(StO 2)的无创光谱方法，使用光谱图中红色和近红色范围内的光波长。基于nirs的设备可以可靠地识别组织中氧合血红蛋白(HbO 2)和脱氧血红蛋白(hbb)的比例，因此能够确定与肢体缺血相关的氧去饱和。许多商业设备可供临床使用。目前使用现有近红外光谱设备的一些限制是成本和患者床位周围的体积。因此，它们很少在手术室和重症监护病房之外使用，在这些地方，患者相对不动，护士和患者的比例较低，使得工作人员可以在病床空间管理多个有线设备。本前瞻性研究的目的是:1。评估在健康志愿者肢体缺血止血带模型中使用一种新型无线近红外光谱装置检测组织StO 2的可行性。摘要框

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Innovations Medicine-Medicine (all)

CiteScore

4.20

自引率

0.00%

发文量

期刊介绍： Healthcare is undergoing a revolution and novel medical technologies are being developed to treat patients in better and faster ways. Mobile revolution has put a handheld computer in pockets of billions and we are ushering in an era of mHealth. In developed and developing world alike healthcare costs are a concern and frugal innovations are being promoted for bringing down the costs of healthcare. BMJ Innovations aims to promote innovative research which creates new, cost-effective medical devices, technologies, processes and systems that improve patient care, with particular focus on the needs of patients, physicians, and the health care industry as a whole and act as a platform to catalyse and seed more innovations. Submissions to BMJ Innovations will be considered from all clinical areas of medicine along with business and process innovations that make healthcare accessible and affordable. Submissions from groups of investigators engaged in international collaborations are especially encouraged. The broad areas of innovations that this journal aims to chronicle include but are not limited to: Medical devices, mHealth and wearable health technologies, Assistive technologies, Diagnostics, Health IT, systems and process innovation.