We have pioneered the use of cerebral near infrared spectroscopy (NIRS) for the non-invasive measurement of cerebral oxygenation and haemodynamics in critically ill brain-injured adults and have for the first time investigated the use of NIRS to detect non-invasively cellular metabolic derangements in real time at the bedside.

We develop and use novel optical techniques to measure changes in cerebral oxygenation, perfusion and energy status and have developed a clinical paradigm which generates changes in levels of cytochrome c oxidase (CCO as a measure of cellular mitochondrial function. On-going studies in a large series of brain-injured patients will identify trends in CCO during disease progression and treatment and allow us to cross correlate, validate and quantify the CCO changes against established components of multi-modal cerebral monitoring, particularly cerebral microdialysis. We will develop interventional studies to examine the effects on outcome of intervention targeted to early warning of secondary cerebral ischaemia/hypoxia.

On-going instrumentation and software development will deliver on-line data analysis and the provision of user friendly and clinically relevant information at the bedside from different regions of the brain simultaneously.