Towards detection of brain injury using multimodal non-invasive neuromonitoring in adults undergoing extracorporeal membrane oxygenation

Irfaan A Dar; Imad R Khan; Ross K Maddox; Olga Selioutski; Kelly L Donohue; Mark A Marinescu; Sunil M Prasad; Nadim H Quazi; Jack S Donlon; Emily A Loose; Gabriel A Ramirez; Jingxuan Ren; Joseph B Majeski; Kenneth Abramson; Turgut Durduran; David R Busch; Regine Choe

doi:10.1364/BOE.401641

Towards detection of brain injury using multimodal non-invasive neuromonitoring in adults undergoing extracorporeal membrane oxygenation

Biomed Opt Express. 2020 Oct 19;11(11):6551-6569. doi: 10.1364/BOE.401641. eCollection 2020 Nov 1.

Authors

Irfaan A Dar¹, Imad R Khan², Ross K Maddox^{1

3}, Olga Selioutski⁴, Kelly L Donohue², Mark A Marinescu⁵, Sunil M Prasad⁶, Nadim H Quazi⁷, Jack S Donlon¹, Emily A Loose⁷, Gabriel A Ramirez¹, Jingxuan Ren¹, Joseph B Majeski¹, Kenneth Abramson⁸, Turgut Durduran^{9

10}, David R Busch^{11

12}, Regine Choe^{1

13}

Affiliations

¹ Department of Biomedical Engineering, University of Rochester, Rochester, New York 14620, USA.
² Department of Neurology, Division of Neurocritical Care, University of Rochester Medical Center, Rochester, New York 14642, USA.
³ Department of Neuroscience, University of Rochester, Rochester, New York 14620, USA.
⁴ Department of Neurology, Division of Epilepsy, University of Rochester Medical Center, Rochester, New York 14642, USA.
⁵ Department of Medicine, Division of Cardiology, University of Rochester Medical Center, Rochester, New York 14642, USA.
⁶ Department of Surgery, Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, New York 14642, USA.
⁷ Department of Biology, University of Rochester, Rochester, New York 14620, USA.
⁸ Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
⁹ ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), 08860, Spain.
¹⁰ Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Castelldefels (Barcelona), 08015, Spain.
¹¹ Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA.
¹² Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA.
¹³ Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York 14620, USA.

Abstract

Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass that provides life-saving support to critically ill patients whose illness is progressing despite maximal conventional support. Use in adults is expanding, however neurological injuries are common. Currently, the existing brain imaging tools are a snapshot in time and require high-risk patient transport. Here we assess the feasibility of measuring diffuse correlation spectroscopy, transcranial Doppler ultrasound, electroencephalography, and auditory brainstem responses at the bedside, and developing a cerebral autoregulation metric. We report preliminary results from two patients, demonstrating feasibility and laying the foundation for future studies monitoring neurological health during ECMO.