Implementation of hyperspectral imaging in a trauma resuscitation room: a randomized controlled trial

Abstract

Background: Hyperspectral imaging (HSI) is a novel imaging technology with the ability to assess microcirculatory impairment. We aimed to assess feasibility of performing HSI, a noninvasive, contactless method to assess microcirculatory alterations, during trauma resuscitation care. Methods: This randomized controlled clinical trial was conducted in a dedicated trauma resuscitation room of a level one trauma center. We included adult patients who were admitted to the trauma resuscitation room. Patients were allocated in a 1:1 ratio to the HSI group (intervention) or control group. In addition to the standard of care, patients in the intervention group had two hyperspectral recordings (HSR) of their hand palm taken. Primary outcomes were the treatment duration of the primary survey (until end of ABCDE-evaluation, ultrasound and evaluation by the trauma team) and the total resuscitation room care (until transport to definitive care) as well as the ability to perform measurements from all HSR. Secondary outcomes were analyses from the intervention group compared to HSI measurements of 26 healthy volunteers including an analysis based on the ISS (Injury severity score) (< 16 vs. ≥ 16). Care givers, and those assessing the outcomes were blinded to group assignment. Results: Our final analysis included 51 patients, with 25 and 26 allocated to the control and intervention group, respectively. There was a statistically significant shorter median duration of the primary survey in the control group (03:22 min [Q1–Q3 03:00–03:51]) compared to the intervention group (03:59 min [Q1–Q3 03:29–04:35]) with a difference of −37 s (95% CI −66 to −12). Total resuscitation room care was longer in the control group, but without significance: 60 s (95% CI −60 to 180). From 52 HSI, we were able to perform hyperspectral measurements on all images, with significant differences between injured patients and healthy volunteers. Conclusion: HSI proved to be feasible during resuscitation room care and can provide valuable information on the microcirculatory state. Trial registration DRKS DRKS00024047–www.drks.de. Registered on 13th April 2021.