The CritiView: a new fiber optic based optical device for the assessment of tissue vitality

The most important parameter that reflects the balance between oxygen supply and demand in tissues is the mitochondrial NADH redox state that could be monitored In vivo. Nevertheless single parameter monitoring is limited in the interpretation capacity of the very complicated pathophysiological events, therefore three more parameters were added to the NADH and the multiparametric monitoring system was used in experimental and clinical studies. In our previous paper1 we described the CritiView (CRV1) including a fiber optic probe that monitor four physiological parameters in real time. In the new model (CRV3) several factors such as UV safety, size and price of the device were improved significantly. The CRV3 enable to monitor the various parameters in three different locations in the tissue thus increasing the reliability of the data due to the better statistics. The connection between the device and the monitored tissue could be done by various types of probes. The main probe that was tested also in clinical studies was a special 3 points probe that includes 9 optical fibers (3 in each point) that was embedded in a three way Foley catheter. This catheter enabled the monitoring of urethral wall vitality as an indicator of the development of body metabolic emergency state. The three point probe was tested in the brain exposed to the lack of oxygen (Anoxia, Hypoxia or Ischemia). A decrease in blood oxygenation and a large increase in mitochondrial NADH fluorescence were recorded. The microcirculatory blood flow increased during anoxia and hypoxia and decreased significantly under ischemia.