Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions

To date, the clinical use of functional near-infrared spectroscopy (NIRS) to detect cerebral ischemia has been largely limited to surgical settings, where motion artifacts are minimal. In this study, we present novel techniques to address the challenges of using NIRS to monitor ambulatory patients w...

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Autores principales:	Ardy Wong, Lucy Robinson, Seena Soroush, Aditi Suresh, Dia Yang, Kelechi Madu, Meera N. Harhay, Kambiz Pourrezaei
Formato:	article
Lenguaje:	EN
Publicado:	World Scientific Publishing 2021
Materias:	motion artifact removal cerebral oxygenation end-stage kidney disease near-infrared spectroscopy Technology T Optics. Light QC350-467
Acceso en línea:	https://doaj.org/article/3aabb459348046519861b0596cb20350
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spelling	oai:doaj.org-article:3aabb459348046519861b0596cb203502021-11-23T13:04:53ZAssessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions1793-54581793-720510.1142/S1793545821500164https://doaj.org/article/3aabb459348046519861b0596cb203502021-11-01T00:00:00Zhttp://www.worldscientific.com/doi/epdf/10.1142/S1793545821500164https://doaj.org/toc/1793-5458https://doaj.org/toc/1793-7205To date, the clinical use of functional near-infrared spectroscopy (NIRS) to detect cerebral ischemia has been largely limited to surgical settings, where motion artifacts are minimal. In this study, we present novel techniques to address the challenges of using NIRS to monitor ambulatory patients with kidney disease during approximately eight hours of hemodialysis (HD) treatment. People with end-stage kidney disease who require HD are at higher risk for cognitive impairment and dementia than age-matched controls. Recent studies have suggested that HD-related declines in cerebral blood flow might explain some of the adverse outcomes of HD treatment. However, there are currently no established paradigms for monitoring cerebral perfusion in real-time during HD treatment. In this study, we used NIRS to assess cerebral hemodynamic responses among 95 prevalent HD patients during two consecutive HD treatments. We observed substantial signal attenuation in our predominantly Black patient cohort that required probe modifications. We also observed consistent motion artifacts that we addressed by developing a novel NIRS methodology, called the HD cerebral oxygen demand algorithm (HD-CODA), to identify episodes when cerebral oxygen demand might be outpacing supply during HD treatment. We then examined the association between a summary measure of time spent in cerebral deoxygenation, derived using the HD-CODA, and hemodynamic and treatment-related variables. We found that this summary measure was associated with intradialytic mean arterial pressure, heart rate, and volume removal. Future studies should use the HD-CODA to implement studies of real-time NIRS monitoring for incident dialysis patients, over longer time frames, and in other dialysis modalities.Ardy WongLucy RobinsonSeena SoroushAditi SureshDia YangKelechi MaduMeera N. HarhayKambiz PourrezaeiWorld Scientific Publishingarticlemotion artifact removalcerebral oxygenationend-stage kidney diseasenear-infrared spectroscopyTechnologyTOptics. LightQC350-467ENJournal of Innovative Optical Health Sciences, Vol 14, Iss 6, Pp 2150016-1-2150016-16 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	motion artifact removal cerebral oxygenation end-stage kidney disease near-infrared spectroscopy Technology T Optics. Light QC350-467
spellingShingle	motion artifact removal cerebral oxygenation end-stage kidney disease near-infrared spectroscopy Technology T Optics. Light QC350-467 Ardy Wong Lucy Robinson Seena Soroush Aditi Suresh Dia Yang Kelechi Madu Meera N. Harhay Kambiz Pourrezaei Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions
description	To date, the clinical use of functional near-infrared spectroscopy (NIRS) to detect cerebral ischemia has been largely limited to surgical settings, where motion artifacts are minimal. In this study, we present novel techniques to address the challenges of using NIRS to monitor ambulatory patients with kidney disease during approximately eight hours of hemodialysis (HD) treatment. People with end-stage kidney disease who require HD are at higher risk for cognitive impairment and dementia than age-matched controls. Recent studies have suggested that HD-related declines in cerebral blood flow might explain some of the adverse outcomes of HD treatment. However, there are currently no established paradigms for monitoring cerebral perfusion in real-time during HD treatment. In this study, we used NIRS to assess cerebral hemodynamic responses among 95 prevalent HD patients during two consecutive HD treatments. We observed substantial signal attenuation in our predominantly Black patient cohort that required probe modifications. We also observed consistent motion artifacts that we addressed by developing a novel NIRS methodology, called the HD cerebral oxygen demand algorithm (HD-CODA), to identify episodes when cerebral oxygen demand might be outpacing supply during HD treatment. We then examined the association between a summary measure of time spent in cerebral deoxygenation, derived using the HD-CODA, and hemodynamic and treatment-related variables. We found that this summary measure was associated with intradialytic mean arterial pressure, heart rate, and volume removal. Future studies should use the HD-CODA to implement studies of real-time NIRS monitoring for incident dialysis patients, over longer time frames, and in other dialysis modalities.
format	article
author	Ardy Wong Lucy Robinson Seena Soroush Aditi Suresh Dia Yang Kelechi Madu Meera N. Harhay Kambiz Pourrezaei
author_facet	Ardy Wong Lucy Robinson Seena Soroush Aditi Suresh Dia Yang Kelechi Madu Meera N. Harhay Kambiz Pourrezaei
author_sort	Ardy Wong
title	Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions
title_short	Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions
title_full	Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions
title_fullStr	Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions
title_full_unstemmed	Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions
title_sort	assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (nirs): challenges and solutions
publisher	World Scientific Publishing
publishDate	2021
url	https://doaj.org/article/3aabb459348046519861b0596cb20350
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Assessment of cerebral oxygenation response to hemodialysis using near-infrared spectroscopy (NIRS): Challenges and solutions

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