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Early Detection of Pressure Injury Development with Diffuse Correlation Spectroscopy
Start Date: 11/9/2017Start Time: 3:00 PM
End Date: 11/9/2017End Time: 5:00 PM
Event Description
BIOMED PhD Research Proposal

Title:
Early Detection of Pressure Injury Development with Diffuse Correlation Spectroscopy

Speaker:
Alec Lafontant, PhD Candidate, School of Biomedical Engineering, Science and Health Systems

Advisors:
Leonid Zubkov, PhD, Research Professor, School of Biomedical Engineering, Science and Health Systems

Michael Neidrauer, PhD, Assistant Research Professor, School of Biomedical Engineering, Science and Health Systems

Abstract:
Patients with limited mobility, such as spinal cord injury (SCI) patients are at high risk of PI development due to the prolonged pressure applied to tissue near bony prominences. Current clinical assessment methods for deep tissue injury (DTI) and PI progression, such as the Braden Scale, rely on visual analysis of the skin surface, mobility, and nutrition; these methods have sensitivity and specificity of just 74% and 75% respectively. It is necessary to develop an objective method to analyze early stage PIs, which would allow for clinicians to provide more aggressive treatment options for patients identified as high risk and as a result enhance the sensitivity and specificity of early PI detection in comparison with current assessment tools.

The goal of this research is to develop an objective method for early detection of pressure injury (PI) using noninvasive, near-infrared spectroscopic devices including diffuse correlation spectroscopy (DCS) and diffuse near infrared spectroscopy (DNIRS) to measure blood flow and tissue oxygenation, respectively, allowing for clinicians to provide more aggressive treatment options for patients identified as high risk and also enhance the sensitivity and specificity of early PI detection in comparison with current assessment tools.

DCS measures microcirculatory blood flow in the form of a temporal correlation function (TCF) of scattered light intensity based on photon arrival times. Experimental TCFs can be used to calculate the exponential time delay (τ_exp) which is correlated to red cell mobility. This technology has been previously used in studies for the detection and monitoring of breast cancer tumors and neurological conditions, such as the degree of brain injury following a stroke, sleep apnea, and brain activations. Sixteen rehabilitation patients were recruited- 4 of which developed open pressure injuries (PO) within four weeks of enrolling while twelve patients did not (PNO).

The protocol was designed to measure during three stages- baseline, applied pressure, and released pressure. During the baseline stage the patient laid on his or her side and the probe was gently held against the area of redness for 1-2 minutes. Measured 〖 τ〗_exp values were approximately five times smaller in POs compared to PNOs (p=0.0015), which corresponds to faster blood flow in the area of redness. The patient then laid supine on top of the probe in order to apply pressure from body weight to the area of redness for 8-10 minutes and POs showed a nine-fold decrease in blood flow compared with PNOs who only showed a two-fold decrease in the ischemia stage. Finally, the patient was turned back to the lateral position to measure the released pressure response which we calculated the shift from baseline to reperfusion and saw a decreasing trend from each measurement session for all POs. This could suggest the gradual deterioration of the microvasculature ultimately leading to ulceration, whereas no discernible trend was found in PNOs during this stage.

The data from 16 patients were collected from three different stages resulting in a total of 48 diagnostic conclusions, which have factored into our prediction of pressure injury development: 12 diagnostic conclusions for POs (100% prediction accuracy) and 36 for PNOs (97% prediction accuracy).
Contact Information:
Name: Ken Barbee
Phone: 215-895-1335
Email: barbee@drexel.edu
Alec Lafontant
Location:
Bossone Research Center, Room 709, located at 32nd and Market Streets.
Audience:
  • Undergraduate Students
  • Graduate Students
  • Faculty
  • Staff

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