Abstract
Oxidative stress during fetal development, delivery, or early postnatal life is a major cause of neuropathology, as both hypoxic and hyperoxic insults can significantly damage the developing brain. Despite the obvious need for reliable cerebral oxygenation monitoring, no technology currently exists to monitor cerebral oxygen metabolism continuously and noninvasively in infants at high risk for developing brain injury. Consequently, a rational approach to titrating oxygen supply to cerebral oxygen demand – and thus avoiding hyperoxic or hypoxic insults – is currently lacking. We present a promising method to close this crucial technology gap in the important case of neonates on conventional ventilators. By using cerebral near-infrared spectroscopy and signals from conventional ventilators, along with arterial oxygen saturation, we derive continuous (breath-by-breath) estimates of cerebral venous oxygen saturation, cerebral oxygen extraction fraction, cerebral blood flow, and cerebral metabolic rate of oxygen. The resultant estimates compare very favorably to previously reported data obtained by non-continuous and invasive means from preterm infants in neonatal critical care.
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Notes
- 1.
Note that over the course of the 4-h period, significant trends in cerebral blood flow exist, which contribute to the relatively large standard deviation.
References
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Acknowledgment
This work was supported in part by the United States National Institutes of Health through grants R01EB001659, K24NS057568, and R21HD056009 by the National Institute of Biomedical Imaging and Bioengineering, the National Institute of Neurological Disorders and Stroke, and the National Institute of Child Health and Human Development, respectively. Further support was provided by the Lifebridge Fund.
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The authors declare that they have no conflict of interest.
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Heldt, T., Kashif, F.M., Sulemanji, M., O’Leary, H.M., du Plessis, A.J., Verghese, G.C. (2012). Continuous Quantitative Monitoring of Cerebral Oxygen Metabolism in Neonates by Ventilator-Gated Analysis of NIRS Recordings. In: Schuhmann, M., Czosnyka, M. (eds) Intracranial Pressure and Brain Monitoring XIV. Acta Neurochirurgica Supplementum, vol 114. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0956-4_34
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DOI: https://doi.org/10.1007/978-3-7091-0956-4_34
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