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Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy

1
Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
2
Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham B15 2TH, UK
3
Department of Clinical Neurosciences, Oxford University Hospitals NHS Foundation Trust, Headly Way, Oxford OX3 9DU, UK
4
Imaging and Clinical Sciences, Department of Neuroscience, University G. D’Annunzio of Chieti-Pescara, Institute for Advanced Biomedical Technologies, Via Luigi Polacchi 13, 66100 Chieti, Italy
5
Department of Biochemical Sciences “A. Rossi Fanelli”, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Viale Regina Elena 332, 00185 Rome, Italy
6
National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR- SRMRC), University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham B15 2TH, UK
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2021, 22(3), 1122; https://doi.org/10.3390/ijms22031122
Received: 20 December 2020 / Revised: 18 January 2021 / Accepted: 19 January 2021 / Published: 23 January 2021
(This article belongs to the Section Molecular Neurobiology)
The brain tissue partial oxygen pressure (PbtO2) and near-infrared spectroscopy (NIRS) neuromonitoring are frequently compared in the management of acute moderate and severe traumatic brain injury patients; however, the relationship between their respective output parameters flows from the complex pathogenesis of tissue respiration after brain trauma. NIRS neuromonitoring overcomes certain limitations related to the heterogeneity of the pathology across the brain that cannot be adequately addressed by local-sample invasive neuromonitoring (e.g., PbtO2 neuromonitoring, microdialysis), and it allows clinicians to assess parameters that cannot otherwise be scanned. The anatomical co-registration of an NIRS signal with axial imaging (e.g., computerized tomography scan) enhances the optical signal, which can be changed by the anatomy of the lesions and the significance of the radiological assessment. These arguments led us to conclude that rather than aiming to substitute PbtO2 with tissue saturation, multiple types of NIRS should be included via multimodal systemic- and neuro-monitoring, whose values then are incorporated into biosignatures linked to patient status and prognosis. Discussion on the abnormalities in tissue respiration due to brain trauma and how they affect the PbtO2 and NIRS neuromonitoring is given. View Full-Text
Keywords: tissue partial oxygen pressure; near-infrared spectroscopy; multimodal neuromonitoring; biosignature; traumatic brain injury; tissue respiration; contrast-enhanced near-infrared spectroscopy; diffuse optical tomography; computerized tomography; microdialysis tissue partial oxygen pressure; near-infrared spectroscopy; multimodal neuromonitoring; biosignature; traumatic brain injury; tissue respiration; contrast-enhanced near-infrared spectroscopy; diffuse optical tomography; computerized tomography; microdialysis
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MDPI and ACS Style

Forcione, M.; Ganau, M.; Prisco, L.; Chiarelli, A.M.; Bellelli, A.; Belli, A.; Davies, D.J. Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy. Int. J. Mol. Sci. 2021, 22, 1122. https://doi.org/10.3390/ijms22031122

AMA Style

Forcione M, Ganau M, Prisco L, Chiarelli AM, Bellelli A, Belli A, Davies DJ. Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy. International Journal of Molecular Sciences. 2021; 22(3):1122. https://doi.org/10.3390/ijms22031122

Chicago/Turabian Style

Forcione, Mario, Mario Ganau, Lara Prisco, Antonio M. Chiarelli, Andrea Bellelli, Antonio Belli, and David J. Davies. 2021. "Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy" International Journal of Molecular Sciences 22, no. 3: 1122. https://doi.org/10.3390/ijms22031122

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