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Cells
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Brain Injury, Microcirculation and Tissue Perfusion
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Brain Injury, Microcirculation and Tissue Perfusion

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Cell Microenvironment".

Deadline for manuscript submissions: closed (25 May 2023) | Viewed by 9402

Special Issue Editors

Prof. Dr. Fabio Silvio Taccone

E-Mail Website
Guest Editor
Department of Intensive Care, Erasme Hospital, Brussels, Belgium
Interests: brain injury; cerebral oxygenation; neuromonitoring; microcirculation; tissue perfusion
Special Issues, Collections and Topics in MDPI journals
Dr. Lorenzo Peluso

E-Mail Website
Guest Editor
Department of Intensive Care, Erasme Hospital, Brussels, Belgium
Interests: brain injury; neuromonitoring; cardiac arrest; pupillometry; electroencephalography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The management of brain perfusion plays a pivotal role in the treatment of brain injury. This aspect in particular is widely used to better treat and prevent secondary brain damage in the bedside setting.

Modern neuromonitoring techniques allow to better understand the effect of our treatments in this setting; nevertheless, there is still a lack of knowledge on this topic.

The aim of this Special Issue is to gather pre-clinical and clinical studies that are focused on brain perfusion, microcirculation, and brain oxygenation in different forms of acute brain dysfunction. These studies will help clinicians to better understand the underlying mechanisms of brain hypoxia and hypoperfusion in this setting and to potentially improve the quality of care.

Prof. Dr. Fabio Silvio Taccone
Dr. Lorenzo Peluso
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cells is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cerebral microcirculation
  • brain hypoxia
  • cerebral perfusion
  • cerebral autoregulation
  • critical illness

Published Papers (4 papers)

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17 pages, 7994 KiB  
Article
Comparison of Two Software Packages for Perfusion Imaging: Ischemic Core and Penumbra Estimation and Patient Triage in Acute Ischemic Stroke
by Xiang Zhou, Yashi Nan, Jieyang Ju, Jingyu Zhou, Huanhui Xiao and Silun Wang
Cells 2022, 11(16), 2547; https://doi.org/10.3390/cells11162547 - 16 Aug 2022
Cited by 4 | Viewed by 1987
Abstract
Purpose: Automated postprocessing packages have been developed for managing acute ischemic stroke (AIS). These packages identify ischemic core and penumbra using either computed tomographic perfusion imaging (CTP) data or magnetic resonance imaging (MRI) data. Measurements of abnormal tissues and treatment decisions derived from [...] Read more.
Purpose: Automated postprocessing packages have been developed for managing acute ischemic stroke (AIS). These packages identify ischemic core and penumbra using either computed tomographic perfusion imaging (CTP) data or magnetic resonance imaging (MRI) data. Measurements of abnormal tissues and treatment decisions derived from different vendors can vary. The purpose of this study is to investigate the agreement of volumetric and decision-making outcomes derived from two software packages. Methods: A total of 594 AIS patients (174 underwent CTP and 420 underwent MRI) were included. Imaging data were accordingly postprocessed by two software packages: RAPID and RealNow. Volumetric outputs were compared between packages by performing intraclass correlation coefficient (ICC), Wilcoxon paired test and Bland–Altman analysis. Concordance of selecting patients eligible for mechanical thrombectomy (MT) was assessed based on neuroimaging criteria proposed in DEFUSE3. Results: In the group with CTP data, mean ischemic core volume (ICV)/penumbral volume (PV) was 14.9/81.1 mL via RAPID and 12.6/83.2 mL via RealNow. Meanwhile, in the MRI group, mean ICV/PV were 52.4/68.4 mL and 48.9/61.6 mL via RAPID and RealNow, respectively. Reliability, which was measured by ICC of ICV and PV in CTP and MRI groups, ranged from 0.87 to 0.99. The bias remained small between measurements (CTP ICV: 0.89 mL, CTP PV: −2 mL, MRI ICV: 3.5 mL and MRI PV: 6.8 mL). In comparison with CTP ICV with follow-up DWI, the ICC was 0.92 and 0.94 for RAPID and Realnow, respectively. The bias remained small between CTP ICV and follow-up DWI measurements (Rapid: −4.65 mL, RealNow: −3.65 mL). Wilcoxon paired test showed no significant difference between measurements. The results of patient triage were concordant in 159/174 cases (91%, ICC: 0.90) for CTP and 400/420 cases (95%, ICC: 0.93) for MRI. Conclusion: The CTP ICV derived from RealNow was more accurate than RAPID. The similarity in volumetric measurement between packages did not necessarily relate to equivalent patient triage. In this study, RealNow showed excellent agreement with RAPID in measuring ICV and PV as well as patient triage. Full article
(This article belongs to the Special Issue Brain Injury, Microcirculation and Tissue Perfusion)
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14 pages, 2036 KiB  
Article
Cerebral Autoregulation Assessment Using the Near Infrared Spectroscopy ‘NIRS-Only’ High Frequency Methodology in Critically Ill Patients: A Prospective Cross-Sectional Study
by Jeanette Tas, Nick Eleveld, Melisa Borg, Kirsten D. J. Bos, Anne P. Langermans, Sander M. J. van Kuijk, Iwan C. C. van der Horst, Jan Willem J. Elting and Marcel J. H. Aries
Cells 2022, 11(14), 2254; https://doi.org/10.3390/cells11142254 - 21 Jul 2022
Cited by 2 | Viewed by 2049
Abstract
Impairments in cerebral autoregulation (CA) are related to poor clinical outcome. Near infrared spectroscopy (NIRS) is a non-invasive technique applied to estimate CA. Our general purpose was to study the clinical feasibility of a previously published ‘NIRS-only’ CA methodology in a critically ill [...] Read more.
Impairments in cerebral autoregulation (CA) are related to poor clinical outcome. Near infrared spectroscopy (NIRS) is a non-invasive technique applied to estimate CA. Our general purpose was to study the clinical feasibility of a previously published ‘NIRS-only’ CA methodology in a critically ill intensive care unit (ICU) population and determine its relationship with clinical outcome. Bilateral NIRS measurements were performed for 1–2 h. Data segments of ten-minutes were used to calculate transfer function analyses (TFA) CA estimates between high frequency oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) signals. The phase shift was corrected for serial time shifts. Criteria were defined to select TFA phase plot segments (segments) with ‘high-pass filter’ characteristics. In 54 patients, 490 out of 729 segments were automatically selected (67%). In 34 primary neurology patients the median (q1–q3) low frequency (LF) phase shift was higher in 19 survivors compared to 15 non-survivors (13° (6.3–35) versus 0.83° (−2.8–13), p = 0.0167). CA estimation using the NIRS-only methodology seems feasible in an ICU population using segment selection for more robust and consistent CA estimations. The ‘NIRS-only’ methodology needs further validation, but has the advantage of being non-invasive without the need for arterial blood pressure monitoring. Full article
(This article belongs to the Special Issue Brain Injury, Microcirculation and Tissue Perfusion)
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13 pages, 1587 KiB  
Article
Automated Pupillometry as an Assessment Tool for Intracranial Hemodynamics in Septic Patients
by Ilaria Alice Crippa, Paolo Pelosi, Armin Alvaro Quispe-Cornejo, Antonio Messina, Francesco Corradi, Fabio Silvio Taccone and Chiara Robba
Cells 2022, 11(14), 2206; https://doi.org/10.3390/cells11142206 - 15 Jul 2022
Cited by 3 | Viewed by 2198
Abstract
Impaired cerebral autoregulation (CA) may increase the risk of brain hypoperfusion in septic patients. Sepsis dysregulates the autonomic nervous system (ANS), potentially affecting CA. ANS function can be assessed through the pupillary light reflex (PLR). The aim of this prospective, observational study was [...] Read more.
Impaired cerebral autoregulation (CA) may increase the risk of brain hypoperfusion in septic patients. Sepsis dysregulates the autonomic nervous system (ANS), potentially affecting CA. ANS function can be assessed through the pupillary light reflex (PLR). The aim of this prospective, observational study was to investigate the association between CA and PLR in adult septic patients. Transcranial Doppler was used to assess CA and calculate estimated cerebral perfusion pressure (eCPP) and intracranial pressure (eICP). An automated pupillometer (AP) was used to record Neurological Pupil Index (NPi), constriction (CV) and dilation (DV) velocities. The primary outcome was the relationship between AP-derived variables with CA; the secondary outcome was the association between AP-derived variables with eCPP and/or eICP. Among 40 included patients, 21 (53%) had impaired CA, 22 (55%) had low eCPP (<60 mmHg) and 15 (38%) had high eICP (>16 mmHg). DV was lower in patients with impaired CA compared to others; DV predicted impaired CA with area under the curve, AUROC= 0.78 [95% Confidence Interval, CI 0.63–0.94]; DV < 2.2 mm/s had sensitivity 85% and specificity 69% for impaired CA. Patients with low eCPP or high eICP had lower NPi values than others. NPi was correlated with eCPP (r = 0.77, p < 0.01) and eICP (r = −0.87, p < 0.01). Automated pupillometry may play a role to assess brain hemodynamics in septic patients. Full article
(This article belongs to the Special Issue Brain Injury, Microcirculation and Tissue Perfusion)
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25 pages, 1599 KiB  
Systematic Review
Optical Monitoring in Neonatal Seizures
by Rachel Howard, Runci Li, Kelly Harvey-Jones, Vinita Verma, Frédéric Lange, Geraldine Boylan, Ilias Tachtsidis and Subhabrata Mitra
Cells 2022, 11(16), 2602; https://doi.org/10.3390/cells11162602 - 21 Aug 2022
Cited by 3 | Viewed by 2350
Abstract
Background: Neonatal seizures remain a significant cause of morbidity and mortality worldwide. The past decade has resulted in substantial progress in seizure detection and understanding the impact seizures have on the developing brain. Optical monitoring such as cerebral near-infrared spectroscopy (NIRS) and broadband [...] Read more.
Background: Neonatal seizures remain a significant cause of morbidity and mortality worldwide. The past decade has resulted in substantial progress in seizure detection and understanding the impact seizures have on the developing brain. Optical monitoring such as cerebral near-infrared spectroscopy (NIRS) and broadband NIRS can provide non-invasive continuous real-time monitoring of the changes in brain metabolism and haemodynamics. Aim: To perform a systematic review of optical biomarkers to identify changes in cerebral haemodynamics and metabolism during the pre-ictal, ictal, and post-ictal phases of neonatal seizures. Method: A systematic search was performed in eight databases. The search combined the three broad categories: (neonates) AND (NIRS) AND (seizures) using the stepwise approach following PRISMA guidance. Results: Fifteen papers described the haemodynamic and/or metabolic changes observed with NIRS during neonatal seizures. No randomised controlled trials were identified during the search. Studies reported various changes occurring in the pre-ictal, ictal, and post-ictal phases of seizures. Conclusion: Clear changes in cerebral haemodynamics and metabolism were noted during the pre-ictal, ictal, and post-ictal phases of seizures in neonates. Further studies are necessary to determine whether NIRS-based methods can be used at the cot-side to provide clear pathophysiological data in real-time during neonatal seizures. Full article
(This article belongs to the Special Issue Brain Injury, Microcirculation and Tissue Perfusion)
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