## 1 Introduction
### Near-Infrared Spectroscopy (NIRS)
A promising light-sensitive marker of cellular metabolism is CCO. As the terminal enzyme in the electron transport chain during mitochondrial adenosine triphosphate (ATP) production, changes in CCO oxidation states can indicate whether or not mitochondria are able to compensate for changes in oxygen delivery at the cellular level [25]. Such changes have been validated against other measures of cellular metabolism, including functional magnetic resonance spectroscopy and invasive cerebral microdialysis [26]. Furthermore, changes in the spectral signal of CCO are more specific to brain [27] tissue and less susceptible to interference from extra cranial tissue injury or intracranial hematoma than the measures of HbO and HbR alone. In other experiments, CCO has also been used to assess acute carbon monoxide poisoning, since carbon monoxide binds to CCO and causes mitochondrial dysfunction [28]. Simultaneous measurement of tissue oxygenation with HbO and HbR and metabolic function with CCO will provide greater insights into the hemodynamic events that precede brain injury and could become valuable for guiding therapeutic interventions. The challenge with measuring CCO is that accurately resolving changes in its redox state requires a high-brightness broadband laser covering a wide part of the near-infrared wavelength band. Additionally, a high signal-to-noise ratio is needed because the spectral signal of CCO is less than 10% of that for hemoglobin, hiding changes in CCO concentration within the noise of background signal variation. The upside of developing and using the appropriate light source is that by capturing changes in CCO, we can directly measure neural or tissue metabolism to aid in the diagnosis and management of neurological or organ injury or illness. In this paper, we offer a noninvasive optical imaging approach to capturing CCO in the brain and other tissues or organs using the SCISCCO system, which uses an all-fiber integrated super-continuum light source. The 11-W SCL source generates an output spectrum that extends from 670 nm to 2500 nm, more than encompassing the wavelength range needed to detect CCO, HbO, and HbR. When compared with existing NIRS-based devices that employ a lamp source coupled into a fiber bundle, our SCL provides an almost order of magnitude higher brightness [29]. Moreover, the SCL's pulsed light source and the detection system can be synchronized to further improve the signal-to-noise ratio by almost two orders of magnitude. These features uniquely allow us to obtain the tissue penetration, signal strength, and resolution necessary to provide continuous monitoring of cerebral or tissue oxygenation and metabolism. Beyond assessing brain metabolism, other organs and tissue can also benefit from simultaneous monitoring of metabolic and hemodynamic responses. One example explored in this paper is hemorrhagic shock and treatment methodologies using pilot animal in vivo studies. In particular, the SCISCCO system is applied to swine animal models undergoing induction of HS followed by different treatment modalities, such as partial REBOA (pREBOA) and VPA pharmaceuticals. The optimization of the application of these different treatments can benefit from understanding the viability of the tissue and organs in the injured sections. Thus, the SCISCCO system may be a clinically useful tool for monitoring brain and organ metabolism which could be utilized to diagnose concussions, monitor cerebral metabolism in traumatic brain injury patients, or in an operating or emergency room to gauge at-risk organs' responses to treatments.