Towards mapping cortical hemodynamics through spacetime at the clinical bedside with HD-DOT

Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for profound refractory cardiac or cardiopulmonary failure that carries risks of significant neurologic morbidities. While current standards of care include extensive monitoring of cardiopulmonary physiology, there is currently an unmet need for a new technique that can provide dense longitudinal spatial-temporal assessments of cerebral hemodynamics that may better illuminate when, where, or how injury occurs throughout ECMO maintenance. High-density diffuse optical tomography (HD-DOT) provides an emerging and compelling technology that overcomes the significant limitations of functional magnetic resonance imaging (MRI) to safely and silently image brain function at the point of care. I will discuss the fundamentals of HD-DOT, validations for its image quality, and some initial studies applying HD-DOT to study cerebral hemodynamics of pediatric patients on ECMO.