Rajaram Ajay, Yip Lawrence C M, Milej Daniel, Suwalski Marianne, Kewin Matthew, Lo Marcus, Carson Jeffrey J L, Han Victor, Bhattacharya Soume, Diop Mamadou, de Ribaupierre Sandrine, St Lawrence Keith
Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada.
Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada.
Brain Sci. 2020 Jul 15;10(7):452. doi: 10.3390/brainsci10070452.
Post-hemorrhagic ventricular dilatation (PHVD) is characterized by a build-up of cerebral spinal fluid (CSF) in the ventricles, which increases intracranial pressure and compresses brain tissue. Clinical interventions (i.e., ventricular taps, VT) work to mitigate these complications through CSF drainage; however, the timing of these procedures remains imprecise. This study presents Neonatal NeuroMonitor (NNeMo), a portable optical device that combines broadband near-infrared spectroscopy (B-NIRS) and diffuse correlation spectroscopy (DCS) to provide simultaneous assessments of cerebral blood flow (CBF), tissue saturation (SO), and the oxidation state of cytochrome c oxidase (oxCCO). In this study, NNeMo was used to monitor cerebral hemodynamics and metabolism in PHVD patients selected for a VT. Across multiple VTs in four patients, no significant changes were found in any of the three parameters: CBF increased by 14.6 ± 37.6% ( = 0.09), SO by 1.9 ± 4.9% ( = 0.2), and oxCCO by 0.4 ± 0.6 µM ( = 0.09). However, removing outliers resulted in significant, but small, increases in CBF (6.0 ± 7.7%) and oxCCO (0.1 ± 0.1 µM). The results of this study demonstrate NNeMo's ability to provide safe, non-invasive measurements of cerebral perfusion and metabolism for neuromonitoring applications in the neonatal intensive care unit.
出血后心室扩张（PHVD）的特征是脑室中脑脊液（CSF）积聚，这会增加颅内压并压迫脑组织。临床干预措施（即脑室穿刺引流，VT）通过引流脑脊液来减轻这些并发症；然而，这些操作的时机仍不精确。本研究展示了新生儿神经监测仪（NNeMo），这是一种便携式光学设备，它结合了宽带近红外光谱（B-NIRS）和扩散相关光谱（DCS），可同时评估脑血流量（CBF）、组织饱和度（SO）和细胞色素c氧化酶的氧化状态（oxCCO）。在本研究中，NNeMo用于监测因VT入选的PHVD患者的脑血流动力学和代谢。在4名患者的多次VT过程中，三个参数均未发现显著变化：CBF增加了14.6±37.6%（P = 0.09），SO增加了1.9±4.9%（P = 0.2），oxCCO增加了0.4±0.6 μM（P = 0.09）。然而，去除异常值后，CBF（6.0±7.7%）和oxCCO（0.1±0.1 μM）出现了显著但微小的增加。本研究结果证明了NNeMo能够为新生儿重症监护病房的神经监测应用提供安全、无创的脑灌注和代谢测量。
