## 1 Introduction  
To monitor cerebral, tissue, or organ metabolism and hemodynamics simultaneously, we developed a noninvasive super-continuum infrared spectroscopy of cytochrome c oxidase (SCISCCO) system that is applied to attention test studies in pilot human studies and bleeding control experiments in swine animal studies. High brightness from a super-continuum laser (SCL) permits high signal-to-noise ratio measurements of cytochrome c oxidase (CCO), oxygenated hemoglobin (HbO), and deoxygenated hemoglobin (HbR), and the measurements agree with the expectations based on physiological principles. Laboratory measurements of the CCO solutions as well as human response to breathholding challenges are principled and consistent with previously reported studies. A self-contained, portable, ruggedized, cart-based SCISCCO prototype is assembled and used in swine animal studies with hemorrhage shock followed by treatments using aortic balloons with and without drug supplementation, and the fidelity is verified by comparison with existing laboratory monitors. For diagnosis and monitoring of conditions such as concussions, stroke, traumatic brain injury, and other medical applications, a noninvasive point-of-care method for monitoring tissue metabolism would offer significant value. MRI-based functional imaging technology can detect changes in blood oxygenation, a correlate of neural activity, and thus may offer diagnosis and prediction of prognosis in cases of concussions and other cerebral traumas. However, MRI often has limited utility due to expense, poor portability, and only imaging one point in time rather than continuous monitoring. Potential relationships between changes in cerebral metabolism and patient outcomes cannot be effectively exploited clinically because we lack a practical, low-cost, noninvasive means to monitor cerebral oxygenation and metabolism in the emergency department, operating room, and other medical facilities. Much of what we know about human brain function today in health and disease is offered through the lens of tissue oxygenation. Oxygen is necessary for cellular metabolism. Thus, changes in the flow of oxygenated blood to areas of the brain may reflect a change in underlying neural activity. Functional magnetic resonance (fMRI) uses magnetic fields to noninvasively assess the flow of hemoglobin within cerebral blood vessels, also known as the BOLD signal, an established correlate of regional brain activity. Optical methods such as functional near-infrared spectroscopy (fNIRS) measure changes in the oxidation state of hemoglobin by capturing subtle changes in the color properties of red blood cells. The key advantages of optical imaging devices are that they are silent, compact, portable, and do not interfere with other medical devices, which makes them an ideal bedside complement to fMRI and even computerized tomography scans [1]. Nevertheless, the core limitation of all hemodynamic neuroimaging systems is that they capture changes in blood flow to the brain but not changes in the neural tissue itself. This limitation is of particular importance in the presence of illness or injury, when brain tissue dysfunction may occur without alterations in the regional hemodynamics. As such, there has been particular interest in measuring the optically active markers of cellular function, such as cytochromes. Another area of medical importance is bleeding control, as severe bleeding associated with injuries can lead to death or significant morbidity. Bleeding, especially non-compressible internal bleeding, is a major cause of preventable trauma-related deaths in both military and civilian settings. Most of these fatalities occur within the first hour (\"golden hour\"), and there is a critical need for therapies that can stabilize the patient long enough to transfer them to higher echelons of care for definitive repair of injuries.