A New Framework for the Assessment of Cerebral Hemodynamics Regulation in Neonates Using NIRS

Advances in Experimental Medicine and Biology
Alexander CaicedoS Van Huffel

Abstract

We present a new framework for the assessment of cerebral hemodynamics regulation (CHR) in neonates using near-infrared spectroscopy (NIRS). In premature infants, NIRS measurements have been used as surrogate variables for cerebral blood flow (CBF) in the assessment of cerebral autoregulation (CA). However, NIRS measurements only reflect changes in CBF under constant changes in arterial oxygen saturation (SaO2). This condition is unlikely to be met at the bedside in the NICU. Additionally, CA is just one of the different highly coupled mechanisms that regulate brain hemodynamics. Traditional methods for the assessment of CA do not take into account the multivariate nature of CHR, producing inconclusive results. In this study we propose a newly developed multivariate methodology for the assessment of CHR. This method is able to effectively decouple the influences of SaO2 from the NIRS measurements, and at the same time, produces scores indicating the strength of the coupling between the systemic variables and NIRS recordings. We explore the use of this method, and its derived scores, for the monitoring of CHR using data from premature infants who developed a grade III-IV intra-ventricular hemorrhage during the first 3 days of life.

Citations

Dec 16, 2017·Journal of Perinatology : Official Journal of the California Perinatal Association·M KenosiE M Dempsey
May 7, 2019·Journal of Neurosurgical Anesthesiology·Brian BushKathryn Rosenblatt
Nov 12, 2017·Archives of Disease in Childhood. Fetal and Neonatal Edition·Eugene M Dempsey, Afif Faisal El-Khuffash
Apr 20, 2017·Frontiers in Pediatrics·Zachary A Vesoulis, Amit M Mathur
Dec 8, 2016·Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban·Xu-Fang LiLian Zhang
Mar 30, 2017·Frontiers in Pediatrics·Laura Marie Louise DixPetra Maria Anna Lemmers
Jan 26, 2018·Current Opinion in Pediatrics·Aisling A Garvey, Eugene M Dempsey
Apr 16, 2019·The Journal of Thoracic and Cardiovascular Surgery·Nathalie H P ClaessensPetra M A Lemmers

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