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Near-Infrared Spectroscopy: A Promising Prehospital Tool for Management of Traumatic Brain Injury

Published online by Cambridge University Press:  29 March 2017

Joost Peters
Affiliation:
Department of Trauma Surgery, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands Helicopter Emergency Medical Service, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands
Bas Van Wageningen
Affiliation:
Department of Trauma Surgery, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands Helicopter Emergency Medical Service, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands
Nico Hoogerwerf
Affiliation:
Helicopter Emergency Medical Service, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands Department of Anaesthesiology, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands
Edward Tan
Affiliation:
Department of Trauma Surgery, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands Helicopter Emergency Medical Service, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA The Netherlands
Corresponding

Abstract

Introduction

Early identification of traumatic brain injury (TBI) is essential. Near-infrared spectroscopy (NIRS) can be used in prehospital settings for non-invasive monitoring and the diagnosis of patients who may require surgical intervention.

Methods

The handheld NIRS Infrascanner (InfraScan Inc.; Philadelphia, Pennsylvania USA) uses eight symmetrical scan points to detect intracranial bleeding. A scanner was tested in a physician-staffed helicopter Emergency Medical Service (HEMS). The results were compared with those obtained using in-hospital computed tomography (CT) scans. Scan time, ease-of-use, and change in treatment were scored.

Results

A total of 25 patients were included. Complete scans were performed in 60% of patients. In 15 patients, the scan was abnormal, and in one patient, the scan resulted in a treatment change. Compared with the results of CT scanning, the Infrascanner obtained a sensitivity of 93.3% and a specificity of 78.6%. Most patients had severe TBI with indication for transport to a trauma center prior to scanning. In one patient, the scan resulted in a treatment change. Evaluation of patients with less severe TBI is needed to support the usefulness of the Infrascanner as a prehospital triage tool.

Conclusion

Promising results were obtained using the InfraScan NIRS device in prehospital screening for intracranial hematomas in TBI patients. High sensitivity and good specificity were found. Further research is necessary to determine the beneficial effects of enhanced prehospital screening on triage, survival, and quality of life in TBI patients.

Peters J , Van Wageningen B , Hoogerwerf N , Tan E . Near-Infrared Spectroscopy: A Promising Prehospital Tool for Management of Traumatic Brain Injury. Prehosp Disaster Med. 2017;32(4):414418.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/funding: The Infrascanner used was provided by InfraScan Inc. (Philadelphia, Pennsylvania USA) free of charge. No funding or research support was received by the HEMS, the research team, or the authors of this article. A portion of this article was previously published in Dutch. 18 Permission to publish these data was granted by the publisher. None of the authors had competing interests in relation to this study.

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