Hyperspectral imaging for objective microcirculatory assessment in trauma patients
Marita Klein1, Maik von der Forst1, Nikolai Kaltschmidt1
1Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Heidelberg, Germany.
Scientific Reports
|August 6, 2026
Summary
Hyperspectral imaging (HSI) did not differentiate hemodynamically unstable trauma patients from stable ones. However, HSI correlated with lactate levels and showed a high negative predictive value for mortality, suggesting potential for early trauma team downgrading.
Area of Science:
- Trauma resuscitation
- Microcirculation assessment
- Medical imaging technology
Background:
- Microcirculatory impairment is critical in trauma.
- Early detection of hemodynamic instability is vital.
- Hyperspectral imaging (HSI) offers non-invasive microcirculation assessment.
Purpose of the Study:
- To evaluate HSI's ability to detect early microcirculatory alterations in trauma patients.
- To differentiate between hemodynamically unstable and stable patients during initial resuscitation.
- To assess HSI parameters' correlation with injury severity and mortality.
Main Methods:
- Prospective observational study at a German level I trauma center.
- HSI (TIVITA® 2.0) measurements at three time points.
- Assessed tissue oxygenation saturation (StO₂), tissue water index (TWI), tissue hemoglobin index (THI), and near-infrared perfusion index (NIR).
- Defined hemodynamic instability based on blood pressure, catecholamine use, and hypoperfusion signs.
Main Results:
- No significant difference in initial StO₂ between hemodynamically unstable and stable groups.
- HSI parameters (StO₂, TWI, THI, NIR) did not differentiate between groups.
- Initial elevated lactate levels correlated with significantly lower StO₂.
- Receiver operator curve analysis for mortality showed an area under the curve of 0.677 for StO₂.
Conclusions:
- HSI did not distinguish hemodynamically unstable from stable trauma patients initially.
- HSI correlated with elevated lactate levels.
- High negative predictive value of StO₂ for mortality suggests potential for objective trauma team downgrading.
