AUTHOR=Sauer Martin , Sievert Anika , Wrobel Miroslaw , Schmude Paul , Richter Georg 

TITLE=Acoustocerebrography in septic patients: A randomized and controlled pilot study

JOURNAL=Frontiers in Medical Technology

VOLUME=Volume 4 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medical-technology/articles/10.3389/fmedt.2022.920674

DOI=10.3389/fmedt.2022.920674

ISSN=2673-3129

ABSTRACT=The sepsis-associated encephalopathy (SAE) is a common organ dysfunction in patients with severe sepsis or septic shock and leads to a higher mortality and longer hospital stay. The diagnosis remains an exclusion-process; none of the available measurements are specific for SAE. The aim of the presented prospective and controlled clinical study was to evaluate the possible role of molecular acoustic for determining acute injury of brain in septic patients using an acoustocerebrography (ACG)-system. The ACG is a multi-frequency, transcranial ultrasound method measuring the attenuation and time of flight to detect changes of the brain tissue. 
After approval from the local research ethics committee (of the University Hospital of Rostock: reg.-no: A 2016-0026) 20 patients were included in two study-groups: septic shock group (SG) and control group (CG; postoperative non-septic patients). All patients were measured several times with the ACG at different days. Blood parameters of organ-function, SOFA score and delirium scores (CAM-ICU, ICDSC) were obtained as well. A neurologist examined all patients at inclusion. Predictive analysis was done using a data driven statistical method and by deriving a parameter from the ACG data. The study was registered under “clinicaltrials.gov” (reg.-no: NCT03173196).
All patients of the SG were CAM-ICU positive at inclusion (ICDSC: in mean 4.0) and had clinical signs of SAE. In contrast, all patients of the CG were CAM-ICU negative, with an ICDSC score of 0. The predictive analysis using the ACG data gave an accuracy of 83.4% with a specificity of 89.0% and a sensitivity of 75.1%.
The ACG-method may be helpful for the monitoring and diagnosis of acute brain injury; however, the results of this first report should be verified in further clinical studies. Further investigations should include long-established instruments of SAE diagnosis, e.g. EEG, MRI and biomarkers to compare the results with the ACG-measurements.