Application of near-infrared spectroscopy to triage of traumatic brain injuries in high-intensity conflicts

• Published in: BMJ military health Vol. 170; no. 3; p. 273
• Main Authors: Fawaz, Rayan, Laitselart, P, Morvan, J-B, Riff, J-C, Delmas, J-M, Dagain, A, Joubert, C
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.06.2024
• Subjects: Brain Injuries, Traumatic - diagnostic imaging; Casualties; Consent; Hematoma; Humans; Spectroscopy, Near-Infrared - methods; Spectrum analysis; Traumatic brain injury; Triage - methods; EDUCATION & TRAINING (see Medical Education & Training); ACCIDENT & EMERGENCY MEDICINE; NEUROSURGERY
• ISSN: 2633-3767; 2633-3775
• DOI: 10.1136/military-2022-002301

[...]the absence of immediately available CT scan imaging has prevented medical teams from effectively screening casualties for immediate surgery or evacuation.1 Thus, based on our experiences in the field, military neurosurgeon and intensivist provided a training course dedicated to health servicemen in using a near-infrared spectroscopy device to perform triage of TBI. When screening acute intracranial hematomas, near-infrared spectroscopy measures the differences in the haemoglobin levels between extravascular blood and normal brain tissue, previously described and validated by Robertson et al.2 In this regard, we employed the Infrascanner 2000 (InfraScan, USA), which was designed to detect intracranial hematomas with a volume of >3.5 cc and a depth of <2.5 cm from the surface. Table 1 Results of the measurements during training Supervised training measurements Autonomous training measurements 1st set 2nd set 3rd set 1st set 2nd set 3rd set False positive (%) 3 (15) 4 (20) 0 (0) 6 (30) 4 (20) 2 (10) True negative (%) 17 (85) 16 (80) 20 (100) 14 (70) 16 (80) 18 (90) With the recent war in Ukraine, high-intensity conflicts have returned, after decades of asymmetric warfare.