A look at the neck that could change patient monitoring
Esm茅e de Boer defended her PhD thesis at the Department of Electrical Engineering on January 13th.
Monitoring a patient鈥檚 circulation is a daily challenge in modern medicine, especially during surgery and in intensive care. Carotid ultrasound has long been recognized as an attractive, non-invasive way to do this, but questions remain about how well it can support clinical decision-making. This PhD research of Esm茅e de Boer provides new insights into how carotid ultrasound can be applied, optimized, and interpreted in practice. The main conclusion is that carotid ultrasound is a promising, non-invasive technique for monitoring the circulation. While further research and development are needed before routine hospital use, this work represents an important first step toward that goal.
A healthy circulatory system ensures that organs receive enough oxygen and nutrients. In clinical practice, monitoring circulation 鈥� known as hemodynamic monitoring 鈥� helps doctors detect problems early and guide treatment. Highly accurate methods often require invasive catheters, while safer alternatives provide limited information. This trade-off drives the ongoing search for better, less invasive solutions.
Why focus on the carotid artery?
Carotid ultrasound has been studied for years as a potential monitoring tool. The carotid arteries are located on each side of the neck, close to the heart, and can be visualized easily using ultrasound. With this technique, clinicians can estimate blood flow by measuring vessel diameter and blood velocity. It is safe, relatively inexpensive, and widely available. Recent developments in wearable ultrasound devices make continuous monitoring increasingly feasible 鈥� but only if the measurements are reliable and clinically meaningful.
Improving how measurements are taken
The first part of the thesis of Esm茅e de Boer focuses on optimizing how carotid ultrasound measurements are performed. Traditionally, the ultrasound probe is placed parallel to the blood vessel, an orientation that is difficult to maintain and highly sensitive to movement. This limits its suitability for long-term monitoring.
This research investigated an alternative probe orientation, in which the probe is rotated and tilted relative to the vessel. The results showed that this orientation measures vessel diameter just as accurately and robustly as the traditional approach. The key conclusion is that it is worthwhile to further explore this orientation for practical use, particularly in wearable ultrasound devices.
Understanding clinical added value
The second part of the thesis examines carotid ultrasound in a real clinical setting, focusing on whether it can help predict a drop in blood pressure after spinal anesthesia 鈥� a common complication that can lead to organ damage.
Individual ultrasound measurements alone were not sufficient to predict this blood pressure drop. However, when combined with clinical parameters, carotid ultrasound showed potential value. The conclusion is that further research is needed to identify in which clinical situations carotid ultrasound truly adds value, rather than assuming it will be useful in all cases.
Comparing with existing monitoring methods
The third part of the thesis compares carotid ultrasound with established monitoring techniques, particularly for assessing fluid responsiveness and heart function. When ultrasound-derived parameters were calculated manually, they showed good agreement with existing methods.
This demonstrates that carotid ultrasound has clear potential for evaluating fluid responsiveness and cardiac function, although further work is needed to automate these measurements reliably.
An important first step forward
Taken together, this PhD thesis shows that carotid ultrasound is a promising, non-invasive technique for monitoring the circulation. It does not yet replace invasive gold-standard methods, but it provides valuable insights into how the technique can be optimized, when it adds clinical value, and where its greatest potential lies. As such, this work represents an important first step toward safer and more accessible hemodynamic monitoring in hospitals.
Besides 黑料福利网 also the Catharina Hospital en Philips Research are involved in this research.
Research Institute: EAISI - Eindhoven Artificial Intelligence Systems Institute.
The research is part of the BRUM project (Body-woRn Ultrasound sensing platform for advanced non-invasive patient Monitoring in peri-operative and critical care) for which Massimo Mischi received a grant of NWO.
On this research Cursor wrote the article .
Since Esm茅e won the Beste Pitch Award at the 5 year lustrum event of e/MTIC, Philips wrote this on her research.
Title of PhD thesis: . Supervisors: , Prof. Massimo Mischi, and Dr. Catarina Dinis Fernandes.