Continuous quantitative monitoring of cerebral oxygen metabolism in neonates by ventilator-gated analysis of NIRS recordings.

Acta Neurochirurgica. Supplement
Thomas HeldtGeorge C Verghese

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.

Citations

Sep 1, 2012·Journal of Perinatology : Official Journal of the California Perinatal Association·D SeidelM Knüpfer
Oct 28, 2016·Journal of Clinical Monitoring and Computing·Marilyn HravnakMichael R Pinsky
Jul 26, 2013·Neurocritical Care·Ahilan SivaganesanMichael C Huang
Mar 12, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Vedavalli GovindanAdre du Plessis
Sep 7, 2018·Journal of Neuroscience Methods·R B GovindanAdre du Plessis

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