Noninvasive optical measures of CBV, StO2, CBF index, and rCMRO2 in human premature neonates' brains in the first six weeks of life

Roche-Labarbe, Nadège; Carp, Stefan A.; Surova, Andrea; Patel, Megha; Boas, David A.; Grant, P. Ellen; Franceschini, Maria Angela

doi:10.1002/hbm.21190

Cited by 25 publications

(41 citation statements)

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“…Furthermore, a decrease and increase occurred within the first week of life, which is in agreement with others who investigated this issue in newly born infants (15,16). However, we must also conclude that differences up to 18% can exist between the investigated brain regions for rScO 2 , regardless postnatal age or GA in this cohort of stable preterm and term neonates.…”

Section: Discussionsupporting

confidence: 92%

Cerebral Oxygenation During the First Days of Life in Preterm and Term Neonates: Differences Between Different Brain Regions

2011

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Near-infrared spectroscopy is a noninvasive method for monitoring brain oxygenation. The aim of the study was to investigate differences between cerebral oxygenation in different brain regions in newborns. In a prospective study, we monitored simultaneously left and right frontoparietal and temporo-occipital regional cerebral oxygen saturation (rScO 2 ) and cerebral fractional tissue extraction (cFTOE: (arterial oxygen saturation (SaO 2 ) Ϫ rScO 2 )/SaO 2 ) using near-infrared spectroscopy. A 2-h measurement was performed on d 1, 3, and 7. We included 10 very preterm (GA Ͻ32 wk), 10 preterm (GA: 32-37 wk), and 10 term (GA Ն37 wk) neonates. Limits of agreement for difference of the measurements between different places were determined using the Bland-Altman method. In all subgroups, the rScO 2 and cFTOE values at different regions were not different. Limits of agreement were between Ϯ14 and Ϯ18% for all subgroups. Left-to-right differences were small between different postnatal and GAs. A decrease and increase over time for rScO 2 and cFTOE values was detected for all four brain regions, most pronounced for infants with GA Ͻ32 wk. Cerebral oxygenation in stable preterm and term neonates seems not to differ between different regions of the brain during the early neonatal period. However, variability of individual measurements was quite high as indicated by large limits of agreement. (Pediatr Res 70: 389-394, 2011) N ear-infrared spectroscopy (NIRS) is an increasingly accepted noninvasive method for monitoring regional cerebral oxygen saturation (rScO 2 ) and cerebral fractional tissue oxygen extraction (cFTOE) in preterm and term neonates (1-3).NIRS-determined cerebral oxygenation is usually unilaterally measured on the frontal or frontoparietal part of the neonatal skull (4,5). Although mostly used unilaterally, it has been shown that regional changes in cerebral blood flow and oxygenation may occur because of regional neuronal activation (6 -8). Moreover, Chiron et al. (9) reported a right brain hemisphere dominance in infants, which may imply a different oxygenation/extraction pattern. Recently, we compared leftto-right frontoparietal NIRS-determined rScO 2 in stable preterm and term neonates in the first week of life and found comparable rScO 2 values at both sensor positions, although there was a tendency of the rScO 2 on d 3 to be higher at the right side. Furthermore, left-to-right differences occasionally occurred, in particular, during unstable arterial oxygen saturation (SaO 2 ) patterns suggesting an uneven oxygenation of the brain, at least during and shortly after systemic desaturation (10). Finally, in the scarce bilateral NIRS-determined regional saturation studies done in neonates and infants, only oxygenation of the frontal (11) or frontoparietal (12) regions of the brain were investigated. However, no information is available yet with respect to the temporo-occipital brain regions, which have a higher rate of metabolism than the frontal region of the brain suggesting a more critical equ...

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Section: Discussionsupporting

confidence: 92%

Cerebral Oxygenation During the First Days of Life in Preterm and Term Neonates: Differences Between Different Brain Regions

2011

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“…Within ranges of constant oxygen demand, this may lead to a higher extraction of oxygen (18,19). These results are in line with the study of Roche-Labarbe et al (20). They found an increase in cerebral oxygen consumption during the first 6 wk after birth, which was related to a decrease of Hb over the same period.…”

Section: Discussionsupporting

confidence: 89%

The Relationship Between Electrocerebral Activity and Cerebral Fractional Tissue Oxygen Extraction in Preterm Infants

et al. 2011

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Impaired cerebral oxygen delivery may cause cerebral damage in preterm infants. At lower levels of cerebral perfusion and oxygen concentration, electrocerebral activity is disturbed. The balance between cerebral oxygen delivery and oxygen use can be measured by near-infrared spectroscopy (NIRS), and electrocerebral activity can be measured by amplitude-integrated EEG (aEEG). Our aim was to determine the relationship between regional cerebral tissue oxygen saturation (r c SO 2 ), fractional tissue oxygen extraction (FTOE), and aEEG. We recorded longitudinal digital aEEG and r c SO 2 prospectively in 46 preterm infants (mean GA 29.5 wk, SD 1.7) for 2 hr on the 1st to 5th, 8th, and 15th d after birth. We excluded infants with germinal matrix hemorrhage exceeding grade I and recordings of infants receiving inotropes. FTOE was calculated using transcutaneous arterial oxygen saturation (tcSaO 2 ) and r c SO 2 values: (tcSaO 2 Ϫ r c SO 2 )/tcSaO 2 . aEEG was assessed by calculating the mean values of the 5th, 50th, and 95th centiles of the aEEG amplitudes. The aEEG amplitude centiles changed with increasing GA. FTOE and aEEG amplitude centiles increased significantly with postnatal age. More mature electrocerebral activity was accompanied by increased FTOE. FTOE also increased with increasing postnatal age and decreasing Hb levels. (Pediatr Res 70: 384-388, 2011)

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“…Such effects will be small and can be accounted for by independent NIRS/DOS measurements. For the mean-square particle displacement, in practice, the Brownian model, Dr 2 (t) = 6D B t, fits the observed correlation decay curves fairly well over a wide range of tissue types and source-detector separations, including rat brain [18][19][20][21][22]; mouse tumours [23][24][25][26]; piglet brain [27]; and human skeletal muscle [28][29][30][31][32], human tumours [33][34][35][36][37][38][39] and human brain [40][41][42][43][44][45][46][47][48] (figure 1c). Here, D B is an effective diffusion coefficient that is a few orders of magnitude larger than the traditional thermal Brownian diffusion coefficient of cells in blood given by the Einstein-Smoluchowski relation [49].…”

Section: Introductionmentioning

confidence: 84%

Direct measurement of tissue blood flow and metabolism with diffuse optics

Mesquita

Durdurán

et al. 2011

Phil. Trans. R. Soc. A.

176

189

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Diffuse optics has proven useful for quantitative assessment of tissue oxy-and deoxyhaemoglobin concentrations and, more recently, for measurement of microvascular blood flow. In this paper, we focus on the flow monitoring technique: diffuse correlation spectroscopy (DCS). Representative clinical and pre-clinical studies from our laboratory illustrate the potential of DCS. Validation of DCS blood flow indices in human brain and muscle is presented. Comparison of DCS with arterial spin-labelled MRI, xenon-CT and Doppler ultrasound shows good agreement (0.50 < r < 0.95) over a wide range of tissue types and source detector distances, corroborating the potential of the method to measure perfusion non-invasively and in vivo at the microvasculature level. Alloptical measurements of cerebral oxygen metabolism in both rat brain, following middle cerebral artery occlusion, and human brain, during functional activation, are also described. In both situations, the use of combined DCS and diffuse optical spectroscopy/near-infrared spectroscopy to monitor changes in oxygen consumption by the tissue is demonstrated. Finally, recent results spanning from gene expression-induced angiogenic response to stroke care and cancer treatment monitoring are discussed.

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Noninvasive optical measures of CBV, StO2, CBF index, and rCMRO2 in human premature neonates' brains in the first six weeks of life

Cited by 25 publications

References 0 publications

Cerebral Oxygenation During the First Days of Life in Preterm and Term Neonates: Differences Between Different Brain Regions

Cerebral Oxygenation During the First Days of Life in Preterm and Term Neonates: Differences Between Different Brain Regions

The Relationship Between Electrocerebral Activity and Cerebral Fractional Tissue Oxygen Extraction in Preterm Infants

Direct measurement of tissue blood flow and metabolism with diffuse optics

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