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经颅多普勒:用于新生儿连续脑循环监测的新超声技术。

NeoDoppler: New ultrasound technology for continous cerebral circulation monitoring in neonates.

机构信息

Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.

出版信息

Pediatr Res. 2020 Jan;87(1):95-103. doi: 10.1038/s41390-019-0535-0. Epub 2019 Aug 12.

Abstract

BACKGROUND

There is a strong need for continuous cerebral circulation monitoring in neonatal care, since suboptimal cerebral blood flow may lead to brain injuries in preterm infants and other critically ill neonates. NeoDoppler is a novel ultrasound system, which can be gently fixed to the anterior fontanel and measure cerebral blood flow velocity continuously in different depths of the brain simultaneously. We aimed to study the feasibility, accuracy, and potential clinical applications of NeoDoppler in preterm infants and sick neonates.

METHOD

Twenty-five infants born at different gestational ages with a variety of diagnoses on admission were included. The probe was placed over the anterior fontanel, and blood flow velocity data were continuously recorded. To validate NeoDoppler, we compared the measurements with conventional ultrasound; agreement was assessed using Bland-Altman plots.

RESULTS

NeoDoppler can provide accurate and continuous data on cerebral blood flow velocity in several depths simultaneously. Limits of agreement between the measurements obtained with the two methods were acceptable.

CONCLUSION

By monitoring the cerebral circulation continuously, increased knowledge of cerebral hemodynamics in preterm infants and sick neonates may be acquired. Improved monitoring of these vulnerable brains during a very sensitive period of brain development may contribute toward preventing brain injuries.

摘要

背景

新生儿护理中需要持续进行脑循环监测,因为脑血流灌注不足可能会导致早产儿和其他危重新生儿的脑损伤。NeoDoppler 是一种新型超声系统,它可以轻柔地固定在前囟门上,并同时连续测量大脑不同深度的血流速度。我们旨在研究 NeoDoppler 在早产儿和患病新生儿中的可行性、准确性和潜在临床应用。

方法

本研究纳入了 25 名不同胎龄、入院时伴有多种诊断的婴儿。将探头放置在前囟门上,连续记录血流速度数据。为了验证 NeoDoppler 的准确性,我们将测量结果与传统超声进行了比较,使用 Bland-Altman 图评估了一致性。

结果

NeoDoppler 可以同时准确、连续地提供大脑多个深度的血流速度数据。两种方法测量结果的一致性在可接受范围内。

结论

通过连续监测脑循环,我们可以更深入地了解早产儿和患病新生儿的脑血流动力学。在大脑发育非常敏感的时期,对这些脆弱的大脑进行更完善的监测,可能有助于预防脑损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2758/6960092/050783284415/41390_2019_535_Fig1_HTML.jpg

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