Non-invasive Assessment of Cerebral Blood Flow and Oxygen Metabolism in Neonates during Hypothermic Cardiopulmonary Bypass: Feasibility and Clinical Implications
Citations Over TimeTop 10% of 2017 papers
Abstract
The neonatal brain is extremely vulnerable to injury during periods of hypoxia and/or ischemia. Risk of brain injury is increased during neonatal cardiac surgery, where pre-existing hemodynamic instability and metabolic abnormalities are combined with long periods of low cerebral blood flow and/or circulatory arrest. Our understanding of events associated with cerebral hypoxia-ischemia during cardiopulmonary bypass (CPB) remains limited, largely due to inadequate tools to quantify cerebral oxygen delivery and consumption non-invasively and in real-time. This pilot study aims to evaluate cerebral blood flow (CBF) and oxygen metabolism (CMRO2) intraoperatively in neonates by combining two novel non-invasive optical techniques: frequency-domain near-infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS). CBF and CMRO2 were quantified before, during and after deep hypothermic cardiopulmonary bypass (CPB) in nine neonates. Our results show significantly decreased CBF and CMRO2 during hypothermic CPB. More interestingly, a change of coupling between both variables is observed during deep hypothermic CPB in all subjects. Our results are consistent with previous studies using invasive techniques, supporting the concept of FD-NIRS/DCS as a promising technology to monitor cerebral physiology in neonates providing the potential for individual optimization of surgical management.
Related Papers
- → How would we treat our own heparin-induced thrombocytopenia during cardiac surgery?(2020)16 cited
- → Histological Changes in Neonatal Kidneys after Cardiopulmonary Bypass and Deep Hypothermic Circulatory Arrest(2009)8 cited
- → Regional cerebral blood flow during rewarming of cardiopulmonary bypass correlates with posthypothermic regional glucose use(1998)9 cited
- Changes of pulmonary surfactant activity after deep hypothermic cardiopulmonary bypass in infants(2004)
- → COMPLEMENT ACTIVATION IS RELATED TO CLINICAL CARDIOPULMONARY DYSFUNCTION FOLLOWING PEDIATRIC CARDIAC SURGERY WITH CONTINUOUS ULTRAFILTRATION(2023)