NIRS in Vascular Surgery
Research type
Research Study
Full title
Can NIRS be used as an intra-operative monitor of spinal cord function and predict patient outcome after vascular surgery?
IRAS ID
228830
Contact name
Paul Strutton
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 11 months, 2 days
Research summary
Spinal cord injury following surgery to the main blood vessel in the body, the thoracic aorta, represents the most feared and significant complication. This is a life-changing complication.
Part of the study will look to measure non-invasively (without the need for needles) the blood oxygen levels of the muscles directly adjacent to the spine. The oxygen level of these muscles is thought to reflect that within the spine itself. The oxygen level can be determined by Near-Infrared Spectroscopy (NIRS), which measures how much infra-red light is absorbed by blood. The aim is to use this non-invasive method to monitor blood flow to the spinal cord during complex surgery of the thoracic aorta and eventually devise strategies to prevent it occurring.
Current monitoring of the spinal cord is not routinely carried out during surgery and when it is, it is undertaken using painful electrical stimulation of the brain with needles positioned in the scalp. NIRS does not require high electrical currents or needles and is painless. It has the potential to be used in the awake patient after surgery too.
All surgeries and anaesthetics have the potential to cause post-operative complications. They can increase the length of hospital stay and result in longer recovery times. Anaesthetic and surgical techniques have evolved over the year to reduce the incidence of complications, such as post-operative confusion, however an accurate and reliable method to predict and thus prevent them from occurring, still does not exist.
NIRS could potentially reduce the incidence of certain post-operative complications. Recent studies have shown that by tailoring the anaesthetic to increase the blood oxygen level of the brain during specific cardiac and abdominal surgery, patients had fewer post-operative complications and quicker recovery. A similar study has not been carried out in patients with vascular disease, which we hope to conduct.
REC name
London - Fulham Research Ethics Committee
REC reference
18/LO/0270
Date of REC Opinion
5 Apr 2018
REC opinion
Further Information Favourable Opinion