An automated method for analysis of microcirculation videos for accurate assessment of tissue perfusion.

BACKGROUND: Imaging of the human microcirculation in real-time has the potential to detect injuries and illnesses that disturb the microcirculation at earlier stages and may improve the efficacy of resuscitation. Despite advanced imaging techniques to monitor the microcirculation, there are currently no tools for the near real-time analysis of the videos produced by these imaging systems. An automated system tool that can extract microvasculature information and monitor changes in tissue perfusion quantitatively might be invaluable as a diagnostic and therapeutic endpoint for resuscitation. METHODS: The experimental algorithm automatically extracts microvascular network and quantitatively measures changes in the microcirculation. There are two main parts in the algorithm: video processing and vessel segmentation. Microcirculatory videos are first stabilized in a video processing step to remove motion artifacts. In the vessel segmentation process, the microvascular network is extracted using multiple level thresholding and pixel verification techniques. Threshold levels are selected using histogram information of a set of training video recordings. Pixel-by-pixel differences are calculated throughout the frames to identify active blood vessels and capillaries with flow. RESULTS: Sublingual microcirculatory videos are recorded from anesthetized swine at baseline and during hemorrhage using a hand-held Side-stream Dark Field (SDF) imaging device to track changes in the microvasculature during hemorrhage. Automatically segmented vessels in the recordings are analyzed visually and the functional capillary density (FCD) values calculated by the algorithm are compared for both health baseline and hemorrhagic conditions. These results were compared to independently made FCD measurements using a well-known semi-automated method. Results of the fully automated algorithm demonstrated a significant decrease of FCD values. Similar, but more variable FCD values were calculated using a commercially available software program requiring manual editing. CONCLUSIONS: An entirely automated system for analyzing microcirculation videos to reduce human interaction and computation time is developed. The algorithm successfully stabilizes video recordings, segments blood vessels, identifies vessels without flow and calculates FCD in a fully automated process. The automated process provides an equal or better separation between healthy and hemorrhagic FCD values compared to currently available semi-automatic techniques. The proposed method shows promise for the quantitative measurement of changes occurring in microcirculation during injury.

Combining predictive capabilities of transcranial doppler with electrocardiogram to predict hemorrhagic shock.

Hemorrhagic shock (HS) potentially impacts the chance of survival in most traumatic injuries. Thus, it is highly desirable to maximize the survival rate in cases of blood loss by predicting the occurrence of hemorrhagic shock with biomedical signals. Since analyzing one physiological signal may not enough to accurately predict blood loss severity, two types of physiological signals - Electrocardiography (ECG) and Transcranial Doppler (TCD) - are used to discover the degree of severity. In this study, these degrees are classified as mild, moderate and severe, and also severe and non-severe. The data for this study were generated using the human simulated model of hemorrhage, which is called lower body negative pressure (LBNP). The analysis is done by applying discrete wavelet transformation (DWT). The wavelet-based features are defined using the detail and approximate coefficients and machine learning algorithms are used for classification. The objective of this study is to evaluate the improvement when analyzing ECG and TCD physiological signals together to classify the severity of blood loss. The results of this study show a prediction accuracy of 85.9% achieved by support vector machine in identifying severe/non-severe states.