Leon Rachel L, Ortigoza Eric B, Ali Noorjahan, Angelis Dimitrios, Wolovits Joshua S, Chalak Lina F
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Front Pediatr. 2022 Jan 11;9:748345. doi: 10.3389/fped.2021.748345. eCollection 2021.
Cerebrovascular pressure autoregulation promotes stable cerebral blood flow (CBF) across a range of arterial blood pressures. Cerebral autoregulation (CA) is a developmental process that reaches maturity around term gestation and can be monitored prenatally with both Doppler ultrasound and magnetic resonance imaging (MRI) techniques. Postnatally, there are key advantages and limitations to assessing CA with Doppler ultrasound, MRI, and near-infrared spectroscopy. Here we review these CBF monitoring techniques as well as their application to both fetal and neonatal populations at risk of perturbations in CBF. Specifically, we discuss CBF monitoring in fetuses with intrauterine growth restriction, anemia, congenital heart disease, neonates born preterm and those with hypoxic-ischemic encephalopathy. We conclude the review with insights into the future directions in this field with an emphasis on collaborative science and precision medicine approaches.
脑血管压力自动调节可在一定范围的动脉血压内促进稳定的脑血流量（CBF）。脑自动调节（CA）是一个发育过程，在足月妊娠左右达到成熟，产前可通过多普勒超声和磁共振成像（MRI）技术进行监测。出生后，使用多普勒超声、MRI和近红外光谱评估CA有其关键的优势和局限性。在此，我们回顾这些脑血流量监测技术及其在有脑血流量扰动风险的胎儿和新生儿群体中的应用。具体而言，我们讨论了患有宫内生长受限、贫血、先天性心脏病的胎儿、早产儿以及患有缺氧缺血性脑病的新生儿的脑血流量监测。我们在回顾结尾对该领域的未来方向进行了展望，重点是合作科学和精准医学方法。
