Feasibility of cerebral near-infrared spectroscopy monitoring in the pre-hospital environment

Background Traumatic brain injury (TBI) is a significant cause of death and severe disability from trauma. Pre‐hospital care of patients with TBI may be aided by non‐invasive monitoring of cerebral tissue oxygenation. This pilot observational study was designed to assess if cerebral tissue oximetry using near‐infrared spectroscopy (NIRS) is feasible in the pre‐hospital and transport environment. Methods After ethics committee review, we undertook a feasibility trial in healthy volunteers, transported by road ambulance or helicopter, to assess if monitoring signals could be obtained in the outside environment and during patient transport. Results A total of 33 road ambulance transports and 32 helicopter transports were undertaken. For monitoring commenced outdoors, 33 of 66 probes applied (50%) provided adequate monitoring signal. For road transports, 33 out of 33 transports (100%) resulted in successful bilateral monitoring for more than 70% of the sampling period. For helicopter transports, four transports were cut short by battery failure during the mission and 24 of 28 transports (85.7%) resulted in successful bilateral monitoring for more than 70% of the sampling period. While patient and transport platform movement did not impact on monitoring signals, exposure to ambient light provided a challenge in obtaining monitoring signals that is nevertheless manageable with increased probe shielding. Conclusions NIRS monitoring is feasible in the pre‐hospital environment, opening up the possibility for further research of the role of this modality in this setting.