One of the only currently available treatment options to potentially improve neurological recovery after acute spinal cord injury (SCI) is augmentation of mean arterial blood pressure (MAP) to promote blood flow and oxygen delivery to the injured cord. However, to optimize such hemodynamic management, clinicians require a method to monitor the physiological effects of these MAP alterations within the injured cord. Therefore, we investigated the feasibility and effectiveness of using a novel optical sensor, based on near-infrared spectroscopy (NIRS), to monitor real-time spinal cord oxygenation and hemodynamics during the first 7 days post-injury in a porcine model of acute SCI. Six Yucatan miniature pigs underwent a T10 vertebral level contusion-compression injury. Spinal cord oxygenation and hemodynamics were continuously monitored by a minimally invasive custom-made NIRS sensor, and by invasive intraparenchymal (IP) probes to validate the NIRS measures. Episodes of MAP alteration and hypoxia were performed acutely after injury, and at 2 and 7 days post-injury to simulate the types of hemodynamic changes SCI patients experience after injury. The NIRS sensor demonstrated the ability to provide oxygenation and hemodynamic measurements over the 7-day post-SCI period. NIRS measures showed statistically significant correlations with each of the invasive IP measures and MAP changes during episodes of MAP alteration and hypoxia throughout the first week post-injury (p < 0.05). These results indicate that this novel NIRS system can monitor real-time changes in spinal cord oxygenation and hemodynamics over the first 7 days post-injury, and has the ability to detect local tissue changes that are reflective of systemic hemodynamic changes.

中文翻译：

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在急性脊髓损伤的猪模型中，在损伤后的前 7 天内对脊髓氧合和血流动力学进行连续光学监测。

目前唯一可以改善急性脊髓损伤 (SCI) 后神经功能恢复的治疗选择之一是增加平均动脉血压 (MAP) 以促进血液流动和氧气输送到受伤的脊髓。然而，为了优化这种血流动力学管理，临床医生需要一种方法来监测受损脊髓内这些 MAP 改变的生理影响。因此，我们研究了使用基于近红外光谱 (NIRS) 的新型光学传感器在急性 SCI 猪模型受伤后的前 7 天内实时监测脊髓氧合和血流动力学的可行性和有效性. 六头尤卡坦小型猪经历了 T10 椎体水平挫伤 - 压缩损伤。通过微创定制 NIRS 传感器和侵入性脑实质 (IP) 探针持续监测脊髓氧合和血流动力学，以验证 NIRS 测量。MAP 改变和缺氧的发作在受伤后迅速进行，并在受伤后第 2 天和第 7 天进行，以模拟 SCI 患者在受伤后经历的血流动力学变化类型。NIRS 传感器展示了在 SCI 后 7 天期间提供氧合和血流动力学测量的能力。NIRS 测量显示与每个侵入性 IP 测量和 MAP 变化期间的 MAP 改变和损伤后第一周内缺氧期间的显着相关性。MAP 改变和缺氧的发作在受伤后迅速进行，并在受伤后第 2 天和第 7 天进行，以模拟 SCI 患者在受伤后经历的血流动力学变化类型。NIRS 传感器展示了在 SCI 后 7 天期间提供氧合和血流动力学测量的能力。NIRS 测量显示与每个侵入性 IP 测量和 MAP 变化期间的 MAP 改变和损伤后第一周内缺氧期间的显着相关性。MAP 改变和缺氧的发作在受伤后迅速进行，并在受伤后第 2 天和第 7 天进行，以模拟 SCI 患者在受伤后经历的血流动力学变化类型。NIRS 传感器展示了在 SCI 后 7 天期间提供氧合和血流动力学测量的能力。NIRS 测量显示与每个侵入性 IP 测量和 MAP 变化期间的 MAP 改变和损伤后第一周内缺氧期间的显着相关性。p  < 0.05)。这些结果表明，这种新型 NIRS 系统可以在受伤后的前 7 天内监测脊髓氧合和血流动力学的实时变化，并且能够检测反映全身血流动力学变化的局部组织变化。