Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients

Hyperventilation (HV) therapy uses vasoconstriction to reduce intracranial pressure (ICP) by reducing cerebral blood volume. However, as HV also lowers cerebral blood flow (CBF), it may provoke misery perfusion (MP), in which the decrease in CBF is coupled with increased oxygen extraction fraction (...

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Autores: Tagliabue, S., Kacprzak, M., Serra I., I., Maruccia, F., Fischer, J.B., Riveiro-Vilaboa, M., Rey-Perez, A., Expósito, L., Lindner, C., Báguena, M., Durduran, T., Poca, M.A.
Formato: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2023
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2072/536868
Acesso em linha:http://hdl.handle.net/2072/536868
Access Level:acceso abierto
Palavra-chave:Diffuse correlation spectroscopy
hyperventilation treatment
intracranial hypertension
intracranial pressure
misery perfusion0 non-invasive
time-resolved spectroscopy
traumatic brain injury
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spelling Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury PatientsTagliabue, S.Kacprzak, M.Serra I., I.Maruccia, F.Fischer, J.B.Riveiro-Vilaboa, M.Rey-Perez, A.Expósito, L.Lindner, C.Báguena, M.Durduran, T.Poca, M.A.Diffuse correlation spectroscopyhyperventilation treatmentintracranial hypertensionintracranial pressuremisery perfusion0 non-invasivetime-resolved spectroscopytraumatic brain injuryHyperventilation (HV) therapy uses vasoconstriction to reduce intracranial pressure (ICP) by reducing cerebral blood volume. However, as HV also lowers cerebral blood flow (CBF), it may provoke misery perfusion (MP), in which the decrease in CBF is coupled with increased oxygen extraction fraction (OEF). MP may rapidly lead to the exhaustion of brain energy metabolites, making the brain vulnerable to ischemia. MP is difficult to detect at the bedside, which is where transcranial hybrid, near-infrared spectroscopies are promising because they non-invasively measure OEF and CBF. We have tested this technology during HV (~30 min) with bilateral, frontal lobe monitoring to assess MP in 27 sessions in 18 patients with traumatic brain injury. In this study, HV did not lead to MP at a group level ( p > 0.05). However, a statistical approach yielded 89 events with a high probability of MP in 19 sessions. We have characterized each statistically significant event in detail and its possible relationship to clinical and radiological status (decompressive craniectomy and presence of a cerebral lesion), without detecting any statistically significant difference ( p > 0.05). However, MP detection stresses the need for personalized, real-time assessment in future clinical trials with HV, in order to provide an optimal evaluation of the risk-benefit balance of HV. Our study provides pilot data demonstrating that bedside transcranial hybrid near-infrared spectroscopies could be utilized to assess potential MP. © Mary Ann Liebert, Inc.This research was funded by Fundació CELLEX Barcelona, Fundació Mir-Puig, Ajuntament de Barcelona, Agencia Estatal de Investigación (PHOTOMETABO, PID2019-106481RB- C31/10.13039/501100011033), the “Severo Ochoa” Programme for Centres of Excellence in R&D (CEX2019-000910-S), the Obra social “la Caixa” Foundation (LlumMedBcn), Generalitat de Catalunya (CERCA, AGAUR-2017-SGR-1380, RIS3CAT-001-P-001682 CECH), FEDER EC, European Commission Horizon 2020 (LUCA No. 688303, VASCOVID No. 101016087, TinyBrains No. 101017113, Bitmap No. 675332), LASERLAB-EUROPE V (EC H2020 No. 871124), KidsBrainIT (ERA-NET NEURON), and Lux4Med and and la Fundació La Marató de TV3 (2017,2020) MEDLUX and LUX4MED.Mary Ann Liebert Inc.2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion35 p.application/pdfhttp://hdl.handle.net/2072/536868RECERCAT (Dipòsit de la Recerca de Catalunya)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésJournal of NeurotraumaThis Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). https://rightsstatements.org/page/InC/1.0/?language=eninfo:eu-repo/semantics/openAccessoai:recercat.cat:2072/5368682026-05-29T05:05:01Z
dc.title.none.fl_str_mv Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
title Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
spellingShingle Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
Tagliabue, S.
Diffuse correlation spectroscopy
hyperventilation treatment
intracranial hypertension
intracranial pressure
misery perfusion0 non-invasive
time-resolved spectroscopy
traumatic brain injury
title_short Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
title_full Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
title_fullStr Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
title_full_unstemmed Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
title_sort Transcranial, Non-Invasive Evaluation of Potential Misery Perfusion during Hyperventilation Therapy of Traumatic Brain Injury Patients
dc.creator.none.fl_str_mv Tagliabue, S.
Kacprzak, M.
Serra I., I.
Maruccia, F.
Fischer, J.B.
Riveiro-Vilaboa, M.
Rey-Perez, A.
Expósito, L.
Lindner, C.
Báguena, M.
Durduran, T.
Poca, M.A.
author Tagliabue, S.
author_facet Tagliabue, S.
Kacprzak, M.
Serra I., I.
Maruccia, F.
Fischer, J.B.
Riveiro-Vilaboa, M.
Rey-Perez, A.
Expósito, L.
Lindner, C.
Báguena, M.
Durduran, T.
Poca, M.A.
author_role author
author2 Kacprzak, M.
Serra I., I.
Maruccia, F.
Fischer, J.B.
Riveiro-Vilaboa, M.
Rey-Perez, A.
Expósito, L.
Lindner, C.
Báguena, M.
Durduran, T.
Poca, M.A.
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Diffuse correlation spectroscopy
hyperventilation treatment
intracranial hypertension
intracranial pressure
misery perfusion0 non-invasive
time-resolved spectroscopy
traumatic brain injury
topic Diffuse correlation spectroscopy
hyperventilation treatment
intracranial hypertension
intracranial pressure
misery perfusion0 non-invasive
time-resolved spectroscopy
traumatic brain injury
description Hyperventilation (HV) therapy uses vasoconstriction to reduce intracranial pressure (ICP) by reducing cerebral blood volume. However, as HV also lowers cerebral blood flow (CBF), it may provoke misery perfusion (MP), in which the decrease in CBF is coupled with increased oxygen extraction fraction (OEF). MP may rapidly lead to the exhaustion of brain energy metabolites, making the brain vulnerable to ischemia. MP is difficult to detect at the bedside, which is where transcranial hybrid, near-infrared spectroscopies are promising because they non-invasively measure OEF and CBF. We have tested this technology during HV (~30 min) with bilateral, frontal lobe monitoring to assess MP in 27 sessions in 18 patients with traumatic brain injury. In this study, HV did not lead to MP at a group level ( p > 0.05). However, a statistical approach yielded 89 events with a high probability of MP in 19 sessions. We have characterized each statistically significant event in detail and its possible relationship to clinical and radiological status (decompressive craniectomy and presence of a cerebral lesion), without detecting any statistically significant difference ( p > 0.05). However, MP detection stresses the need for personalized, real-time assessment in future clinical trials with HV, in order to provide an optimal evaluation of the risk-benefit balance of HV. Our study provides pilot data demonstrating that bedside transcranial hybrid near-infrared spectroscopies could be utilized to assess potential MP. © Mary Ann Liebert, Inc.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/2072/536868
url http://hdl.handle.net/2072/536868
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Journal of Neurotrauma
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 35 p.
application/pdf
dc.publisher.none.fl_str_mv Mary Ann Liebert Inc.
publisher.none.fl_str_mv Mary Ann Liebert Inc.
dc.source.none.fl_str_mv RECERCAT (Dipòsit de la Recerca de Catalunya)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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