Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility
Abstract We aimed to determine whether optical methods based on bolus tracking of an optical contrast agent are useful for the confirmation of cerebral circulation cessation in patients being evaluated for brain death. Different stages of cerebral perfusion disturbance were compared in three groups...
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Nature Portfolio
2018
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oai:doaj.org-article:3181f18d22dd4d8ba0ffe57d3234f00d2021-12-02T16:08:01ZConfirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility10.1038/s41598-018-25351-62045-2322https://doaj.org/article/3181f18d22dd4d8ba0ffe57d3234f00d2018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-25351-6https://doaj.org/toc/2045-2322Abstract We aimed to determine whether optical methods based on bolus tracking of an optical contrast agent are useful for the confirmation of cerebral circulation cessation in patients being evaluated for brain death. Different stages of cerebral perfusion disturbance were compared in three groups of subjects: controls, patients with posttraumatic cerebral edema, and patients with brain death. We used a time-resolved near-infrared spectroscopy setup and indocyanine green (ICG) as an intravascular flow tracer. Orthogonal partial least squares-discriminant analysis (OPLS-DA) was carried out to build statistical models allowing for group separation. Thirty of 37 subjects (81.1%) were classified correctly (8 of 9 control subjects, 88.9%; 13 of 15 patients with edema, 86.7%; and 9 of 13 patients with brain death, 69.2%; p < 0.0001). Depending on the combination of variables used in the OPLS-DA model, sensitivity, specificity, and accuracy were 66.7–92.9%, 81.8–92.9%, and 77.3–89.3%, respectively. The method was feasible and promising in the demanding intensive care unit environment. However, its accuracy did not reach the level required for brain death confirmation. The potential usefulness of the method may be improved by increasing the depth of light penetration, confirming its accuracy against other methods evaluating cerebral flow cessation, and developing absolute parameters for cerebral perfusion.Wojciech WeiglDaniel MilejAnna GeregaBeata ToczyłowskaPiotr SawoszMichał KacprzakDariusz JanusekStanisław WojtkiewiczRoman ManiewskiAdam LiebertNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-11 (2018) |
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Medicine R Science Q Wojciech Weigl Daniel Milej Anna Gerega Beata Toczyłowska Piotr Sawosz Michał Kacprzak Dariusz Janusek Stanisław Wojtkiewicz Roman Maniewski Adam Liebert Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility |
| description |
Abstract We aimed to determine whether optical methods based on bolus tracking of an optical contrast agent are useful for the confirmation of cerebral circulation cessation in patients being evaluated for brain death. Different stages of cerebral perfusion disturbance were compared in three groups of subjects: controls, patients with posttraumatic cerebral edema, and patients with brain death. We used a time-resolved near-infrared spectroscopy setup and indocyanine green (ICG) as an intravascular flow tracer. Orthogonal partial least squares-discriminant analysis (OPLS-DA) was carried out to build statistical models allowing for group separation. Thirty of 37 subjects (81.1%) were classified correctly (8 of 9 control subjects, 88.9%; 13 of 15 patients with edema, 86.7%; and 9 of 13 patients with brain death, 69.2%; p < 0.0001). Depending on the combination of variables used in the OPLS-DA model, sensitivity, specificity, and accuracy were 66.7–92.9%, 81.8–92.9%, and 77.3–89.3%, respectively. The method was feasible and promising in the demanding intensive care unit environment. However, its accuracy did not reach the level required for brain death confirmation. The potential usefulness of the method may be improved by increasing the depth of light penetration, confirming its accuracy against other methods evaluating cerebral flow cessation, and developing absolute parameters for cerebral perfusion. |
| format |
article |
| author |
Wojciech Weigl Daniel Milej Anna Gerega Beata Toczyłowska Piotr Sawosz Michał Kacprzak Dariusz Janusek Stanisław Wojtkiewicz Roman Maniewski Adam Liebert |
| author_facet |
Wojciech Weigl Daniel Milej Anna Gerega Beata Toczyłowska Piotr Sawosz Michał Kacprzak Dariusz Janusek Stanisław Wojtkiewicz Roman Maniewski Adam Liebert |
| author_sort |
Wojciech Weigl |
| title |
Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility |
| title_short |
Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility |
| title_full |
Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility |
| title_fullStr |
Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility |
| title_full_unstemmed |
Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility |
| title_sort |
confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility |
| publisher |
Nature Portfolio |
| publishDate |
2018 |
| url |
https://doaj.org/article/3181f18d22dd4d8ba0ffe57d3234f00d |
| work_keys_str_mv |
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