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2. Wavelet and time-based cerebral autoregulation analysis using diffuse correlation spectroscopy on adults undergoing extracorporeal membrane oxygenation therapy.

Author

Dar, Irfaan A., Khan, Imad R., Johnson, Thomas W., Helmy, Samantha Marie, Cardona, Jeronimo I., Escobar, Samantha, Selioutski, Olga, Marinescu, Mark A., Zhang, Chloe T., Proctor, Ashley R., AbdAllah, Noura, Busch, David R., Maddox, Ross K., and Choe, Regine

Subjects
*EXTRACORPOREAL membrane oxygenation, *PEARSON correlation (Statistics), *BRAIN tomography, *CARDIOPULMONARY bypass, *WAVELETS (Mathematics), *CEREBRAL circulation
Abstract

Introduction: Adult patients who have suffered acute cardiac or pulmonary failure are increasingly being treated using extracorporeal membrane oxygenation (ECMO), a cardiopulmonary bypass technique. While ECMO has improved the long-term outcomes of these patients, neurological injuries can occur from underlying illness or ECMO itself. Cerebral autoregulation (CA) allows the brain to maintain steady perfusion during changes in systemic blood pressure. Dysfunctional CA is a marker of acute brain injury and can worsen neurologic damage. Monitoring CA using invasive modalities can be risky in ECMO patients due to the necessity of anticoagulation therapy. Diffuse correlation spectroscopy (DCS) measures cerebral blood flow continuously, noninvasively, at the bedside, and can monitor CA. In this study, we compare DCS-based markers of CA in veno-arterial ECMO patients with and without acute brain injury. Methods: Adults undergoing ECMO were prospectively enrolled at a single tertiary hospital and underwent DCS and arterial blood pressure monitoring during ECMO. Neurologic injuries were identified using brain computerized tomography (CT) scans obtained in all patients. CA was calculated over a twenty-minute window via wavelet coherence analysis (WCA) over 0.05 Hz to 0.1 Hz and a Pearson correlation (DCSx) between cerebral blood flow measured by DCS and mean arterial pressure. Results: Eleven ECMO patients who received CT neuroimaging were recruited. 5 (45%) patients were found to have neurologic injury. CA indices WCOH, the area under the curve of the WCA, were significantly higher for patients with neurological injuries compared to those without neurological injuries (right hemisphere p = 0.041, left hemisphere p = 0.041). %DCSx, percentage of time DCSx was above a threshold 0.4, were not significantly higher (right hemisphere p = 0.268, left hemisphere p = 0.073). Conclusion: DCS can be used to detect differences in CA for ECMO patients with neurological injuries compared to uninjured patients using WCA. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Correlations Between Quantitative EEG Parameters and Cortical Blood Flow in Patients Undergoing Extracorporeal Membrane Oxygenation With and Without Encephalopathy

Author

Khan, Imad R., primary, Dar, Irfaan A., additional, Johnson, Thomas W., additional, Loose, Emily, additional, Xu, Yama Y., additional, Santiago, Esmeralda, additional, Donohue, Kelly L., additional, Marinescu, Mark A., additional, Gosev, Igor, additional, Schifitto, Giovanni, additional, Maddox, Ross K., additional, Busch, David R., additional, Choe, Regine, additional, and Selioutski, Olga, additional

Published
2023
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6. Correlations Between EEG Spectral Power and Cerebral Perfusion in Adults Undergoing Extracorporeal Membrane Oxygenation

Author

Khan, Imad R., primary, Dar, Irfaan A., additional, Johnson, Thomas W., additional, Loose, Emily, additional, Xu, Yama Y., additional, Santiago, Esmeralda, additional, Donohue, Kelly L., additional, Marinescu, Mark A., additional, Gosev, Igor, additional, Schifitto, Giovanni, additional, Choe, Regine, additional, and Selioutski, Olga, additional

Published
2022
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7. Cerebral Blood Flow Hemispheric Asymmetry in Comatose Adults Receiving Extracorporeal Membrane Oxygenation

Author

Johnson, Thomas W., primary, Dar, Irfaan A., additional, Donohue, Kelly L., additional, Xu, Yama Y., additional, Santiago, Esmeralda, additional, Selioutski, Olga, additional, Marinescu, Mark A., additional, Maddox, Ross K., additional, Wu, Tong Tong, additional, Schifitto, Giovanni, additional, Gosev, Igor, additional, Choe, Regine, additional, and Khan, Imad R., additional

Published
2022
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10. Increased interhemispheric asymmetry of cerebral blood flow in comatose adult patients on extracorporeal membrane oxygenation

Author

Johnson, Thomas W, primary, Dar, Irfaan, additional, Donohue, Kelly, additional, Xu, Yama Y, additional, Santiago, Esmeralda, additional, Selioutski, Olga, additional, Marinescu, Mark A, additional, Maddox, Ross K, additional, Wu, Tong Tong, additional, Schifitto, Giovanni, additional, Gosev, Igor, additional, Choe, Regine, additional, and Khan, Imad, additional

Published
2021
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12. Towards detection of brain injury using multimodal non-invasive neuromonitoring in adults undergoing extracorporeal membrane oxygenation

Author

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

Published
2020
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13. Longitudinal 3D Blood Flow Distribution Provided by Diffuse Correlation Tomography during Bone Healing in a Murine Fracture Model

Author

Ren, Jingxuan, primary, Han, Songfeng, additional, Proctor, Ashley R., additional, Desa, Danielle E., additional, Ramirez, Gabriel A., additional, Ching‐Roa, Vincent Ralph D., additional, Majeski, Joseph B., additional, Dar, Irfaan A., additional, Barber, Nathaniel E., additional, Forti, Amanda M., additional, Benoit, Danielle S.W., additional, and Choe, Regine, additional

Published
2020
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14. Application of Non-Invasive Cerebral Blood Flow Monitoring Modalities in Adults Undergoing Extracorporeal Membrane Oxygenation

Author

Dar, Irfaan A., primary, Khan, Imad R., additional, Maddox, Ross K., additional, Prasad, Sunil M., additional, Selioutski, Olga, additional, Donohue, Kelly L., additional, Abramson, Kenneth, additional, Yodh, Arjun G., additional, Durduran, Turgut, additional, Busch, David R., additional, and Choe, Regine, additional

Published
2020
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28. Segmentation and Analysis of MRIs of Infants with Dysphagia

Author

Dar, Irfaan A.

Subjects
Biomedical Engineering, Neurosciences, biomedical engineering, neurosciences
Abstract

Neonates are at a rapid stage of development from birth throughout childhood. Impairmentsto certain cortical areas can result in long lasting neuro-cognitive dysfunctions.Disorders to the swallowing neural pathways can have detrimental effects throughout lifecourse since methods to provide nutrition can be comprised. Dysphagia, or the inability toswallow, can be caused by a multitude of reasons, chiefly neurological, but the underlyingdisruptions to the neural pathways are not defined. In this study we investigated the growthof multiple cortical areas involved in the swallowing pathway and categorized feeding outcomeswith neural growth. Results showed that infants that were discharged on oral feedshad higher growth rates compared to those that had a feeding tube implanted. This is thefirst study to look at volumetric analysis for neonates with feeding issues.

Published
2014

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