Method to identify tissue oxygenation state by spectrographic analysis

• US 9,468,380 B2
• Filed: 04/01/2013
• Issued: 10/18/2016
• Est. Priority Date: 03/30/2012
• Status: Active Grant

• Current Assignee: Children's Hospital & Medical Center
• Original Assignee: Children's Hospital & Medical Center
• Inventors: Hirsch, Russel, Racadio, John Miras
• Primary Examiner(s): Humphrey, Louise W
• Assistant Examiner(s): Kosar, Aaron J
• Application Number:
  US13/854,571
• Publication Number:
  US 20130295192A1
• Time in Patent Office: 1,296 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 5/0075 by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy A61B5/0071 takes precedence
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/6848 Needles

Abstract

A system and method for identifying metabolic activity within the heart muscle (myocardium). Metabolic activity is determined through spectrographic analysis of the myocardium. More particularly, oxygen saturation of the myocardium is measured through the spectrographic analysis, and metabolic activity is measured by a decrease in oxygen saturation of the myocardium over time.

Claims

1. A method comprising the steps of:

i. inserting a distal end of a first photonic needle within myocardium;

ii. emitting light from the distal end of the first photonic needle within the myocardium;

iii. detecting light reflected from the myocardium;

iv. processing the reflected light to measure oxygen saturation of the myocardium;

v. establishing a baseline oxygen saturation level of the myocardium;

vi. repeating the emitting, detecting and processing steps;

vii. wherein when the measured oxygen saturation of the myocardium decreases by more than 15% from the baseline oxygen saturation level, then the myocardium is identified as in need of a corrective intervention that would better protect the myocardium in an ischemic environment; and

viii. wherein providing the corrective intervention includes the step of applying a cardioplegia solution to the myocardium to reduce metabolic activity.

2. The method of claim 1, wherein a decrease in the measured oxygen saturation of the myocardium from the baseline oxygen saturation level during protected cardiac arrest is indicative of ongoing myocardial aerobic and metabolic activity.

3. The method of claim 1, wherein the first photonic needle includes a shaft, a first optic fiber within the shaft for emitting light from the distal end, and a second optic fiber within the shaft for receiving the reflected light.

4. The method of claim 1, wherein the step of providing corrective action further includes the step of applying additional cardioplegia solution.

5. The method of claim 1, wherein the step of providing corrective action further includes the step of altering the composition of the cardioplegia solution.

6. The method of claim 1, further comprising the steps of:

ix. inserting a distal end of a second photonic needle within the myocardium;

x. emitting light from the distal end of the second photonic needle within the myocardium;

xi. detecting light reflected from the myocardium;

xii. processing the reflected light to measure oxygen saturation of the myocardium; and

wherein the first photonic needle is positioned within the myocardium at the left ventricle of a heart, and the second photonic needle is positioned within the myocardium at the right ventricle of the heart.

7. The method of claim 1, further comprising the step of placing a myocardial temperature probe adjacent to the first photonic needle to measure temperature of the myocardium.

8. The method of claim 7, further comprising the step of maintaining the measured temperature of the myocardium within 3°

C. of a stable temperature by repeated application of reduced temperature saline.

9. The method of claim 7, wherein the step of applying a cardioplegia solution to the myocardium is at a reduced temperature of between 3°

C. and 5°

C.

10. The method of claim 9, wherein the step of applying a cardioplegia solution to the myocardium includes infusing the cardioplegia solution ante-grade into the aortic root of a heart.

11. The method of claim 7, further comprising the step of applying electrodes to the myocardium to produce an electrocardiogram.

12. A method of measuring oxygen saturation in the myocardium, the method comprising the steps of:

i. inserting a first photonic needle within the myocardium, wherein the first photonic needle includes a shaft, a first optic fiber extending within the shaft and coupled to a light source, and a second optic fiber extending within the shaft and coupled to a light detector;

ii. emitting light from the first optic fiber;

iii. collecting light with the second optic fiber;

iv. obtaining spectroscopic data from light delivered and collected from the myocardium via the photonic needle;

v. processing the spectroscopic data to measure oxygen saturation of the myocardium;

vi. determining active myocardial metabolic activity based upon a change in measured oxygen saturation of the myocardium; and

vii. wherein when the change in measured oxygen saturation of the myocardium is greater than 15%, then the myocardium is identified as in need of a corrective intervention that would better protect the myocardium in an ischemic environment; and

viii. wherein providing the corrective intervention includes the step of applying a cardioplegia solution to the myocardium to reduce metabolic activity.

13. The method of claim 12, further comprising the steps of:

ix. inserting a distal end of a second photonic needle within the myocardium;

x. emitting light from the distal end of the second photonic needle within the myocardium;

xi. detecting light reflected from the myocardium;

xii. processing the reflected light to measure oxygen saturation of the myocardium; and

wherein the first photonic needle is positioned within the myocardium at the left ventricle of a heart, and the second photonic needle is positioned within the myocardium at the right ventricle of the heart.

14. The method of claim 12, further comprising the step of placing a myocardial temperature probe adjacent to the first photonic needle to measure temperature of the myocardium.

15. The method of claim 14, further comprising the step of maintaining the measured temperature of the myocardium within 3°

C. of a stable temperature by repeated application of reduced temperature saline.

16. The method of claim 14, wherein the step of applying a cardioplegia solution to the myocardium is at a reduced temperature of between 3°

C. and 5°

C.

17. The method of claim 16, wherein the step of applying a cardioplegia solution to the myocardium includes infusing the cardioplegia solution ante-grade into the aortic root of a heart.

18. The method of claim 14, further comprising the step of applying electrodes to the myocardium to produce an electrocardiogram.