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Arcagok BC, Bilgen H, Ozdemir H, Memisoglu A, Save D, Ozek E. Early or delayed cord clamping during transition of term newborns: does it make any difference in cerebral tissue oxygenation? Ital J Pediatr 2024; 50:133. [PMID: 39075594 PMCID: PMC11288115 DOI: 10.1186/s13052-024-01707-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND According to the World Health Organization's recommendation, delayed cord clamping in term newborns can have various benefits. Cochrane metaanalyses reported no differences for mortality and early neonatal morbidity although a limited number of studies investigated long-term neurodevelopmental outcomes. The aim of our study is to compare the postnatal cerebral tissue oxygenation values in babies with early versus delayed cord clamping born after elective cesarean section. METHODS In this study, a total of 80 term newborns delivered by elective cesarean section were included. Infants were randomly grouped as early (clamped within 15 s, n:40) and delayed cord clamping (at the 60th second, n:40) groups. Peripheral arterial oxygen saturation (SpO2) and heart rate were measured by pulse oximetry while regional oxygen saturation of the brain (rSO2) was measured with near-infrared spectrometer. Fractional tissue oxygen extraction (FTOE) was calculated for every minute between the 3rd and 15th minute after birth. (FTOE = pulse oximetry value-rSO2/pulse oximetry value). The measurements were compared for both groups. RESULTS The demographical characteristics, SpO2 levels (except postnatal 6th, 8th, and 14th minutes favoring DCC p < 0.05), heart rates and umbilical cord blood gas values were not significantly different between the groups (p > 0.05). rSO2 values were significantly higher while FTOE values were significantly lower for every minute between the 3rd and 15th minutes after birth in the delayed cord clamping group (p < 0.05). CONCLUSION Our study revealed a significant increase in cerebral rsO2 values and a decrease in FTOE values in the delayed cord clamping (DCC) group, indicating a positive impact on cerebral oxygenation and hemodynamics. Furthermore, the DCC group exhibited a higher proportion of infants with cerebral rSO2 levels above the 90th percentile. This higher proportion, along with a lower of those with such parameter below the 10th percentile, suggest that DCC may lead to the targeted/optimal cerebral oxygenetaion of these babies. As a result, we recommend measuring cerebral oxygenation, in addition to peripheral SpO2, for infants experiencing perinatal hypoxia and receiving supplemental oxygen.
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Affiliation(s)
- Baran Cengiz Arcagok
- Department of Pediatrics, Division of Neonatology, School of Medicine, Acibadem University, Istanbul, Turkey.
| | - Hulya Bilgen
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Hulya Ozdemir
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Asli Memisoglu
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Dilsad Save
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
| | - Eren Ozek
- Department of Pediatrics, Division of Neonatology, School of Medicine, Marmara University, Istanbul, Turkey
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Passera S, De Carli A, Fumagalli M, Contini D, Pesenti N, Amendola C, Giovannella M, Durduran T, Weigel UM, Spinelli L, Torricelli A, Greisen G. Cerebrovascular reactivity to carbon dioxide tension in newborns: data from combined time-resolved near-infrared spectroscopy and diffuse correlation spectroscopy. NEUROPHOTONICS 2023; 10:045003. [PMID: 37841558 PMCID: PMC10576436 DOI: 10.1117/1.nph.10.4.045003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/30/2023] [Accepted: 08/18/2023] [Indexed: 10/17/2023]
Abstract
Significance Critically ill newborns are at risk of brain damage from cerebrovascular disturbances. A cerebral hemodynamic monitoring system would have the potential role to guide targeted intervention. Aim To obtain, in a population of newborn infants, simultaneous near-infrared spectroscopy (NIRS)-based estimates of cerebral tissue oxygen saturation (StO 2 ) and blood flow during variations of carbon dioxide tension (pCO 2 ) levels within physiologic values up to moderate permissive hypercapnia, and to examine if the derived estimate of metabolic rate of oxygen would stay constant, during the same variations. Approach We enrolled clinically stable mechanically ventilated newborns at postnatal age > 24 h without brain abnormalities at ultrasound. StO 2 and blood flow index were measured using a non-invasive device (BabyLux), which combine time-resolved NIRS and diffuse-correlation spectroscopy. The effect of changes in transcutaneous pCO 2 on StO 2 , cerebral blood flow (CBF), and cerebral metabolic rate of oxygen index (tCMRO 2 i ) were estimated. Results Ten babies were enrolled and three were excluded. Median GA at enrollment was 39 weeks and median weight 2720 g. StO 2 increased 0.58% (95% CI 0.55; 0.61, p < 0.001 ), CBF 2% (1.9; 2.3, p < 0.001 ), and tCMRO 2 0.3% (0.05; 0.46, p = 0.017 ) per mmHg increase in pCO 2 . Conclusions BabyLux device detected pCO 2 -induced changes in cerebral StO 2 and CBF, as expected. The small statistically significant positive relationship between pCO 2 and tCMRO 2 i variation is not considered clinically relevant and we are inclined to consider it as an artifact.
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Affiliation(s)
- Sofia Passera
- NICU Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
| | - Agnese De Carli
- NICU Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
| | - Monica Fumagalli
- NICU Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
- University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, Milan, Italy
| | - Nicola Pesenti
- University of Milano-Bicocca, Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, Milan, Italy
| | | | - Martina Giovannella
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Casteldefells, Spain
| | - Turgut Durduran
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Casteldefells, Spain
- ICREA – Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | | | - Lorenzo Spinelli
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Alessandro Torricelli
- Politecnico di Milano, Dipartimento di Fisica, Milan, Italy
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Gorm Greisen
- Rigshospitalet and University of Copenhagen, Department of Neonatology, Copenhagen, Denmark
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Scano A, Guanziroli E, Brambilla C, Amendola C, Pirovano I, Gasperini G, Molteni F, Spinelli L, Molinari Tosatti L, Rizzo G, Re R, Mastropietro A. A Narrative Review on Multi-Domain Instrumental Approaches to Evaluate Neuromotor Function in Rehabilitation. Healthcare (Basel) 2023; 11:2282. [PMID: 37628480 PMCID: PMC10454517 DOI: 10.3390/healthcare11162282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
In clinical scenarios, the use of biomedical sensors, devices and multi-parameter assessments is fundamental to provide a comprehensive portrait of patients' state, in order to adapt and personalize rehabilitation interventions and support clinical decision-making. However, there is a huge gap between the potential of the multidomain techniques available and the limited practical use that is made in the clinical scenario. This paper reviews the current state-of-the-art and provides insights into future directions of multi-domain instrumental approaches in the clinical assessment of patients involved in neuromotor rehabilitation. We also summarize the main achievements and challenges of using multi-domain approaches in the assessment of rehabilitation for various neurological disorders affecting motor functions. Our results showed that multi-domain approaches combine information and measurements from different tools and biological signals, such as kinematics, electromyography (EMG), electroencephalography (EEG), near-infrared spectroscopy (NIRS), and clinical scales, to provide a comprehensive and objective evaluation of patients' state and recovery. This multi-domain approach permits the progress of research in clinical and rehabilitative practice and the understanding of the pathophysiological changes occurring during and after rehabilitation. We discuss the potential benefits and limitations of multi-domain approaches for clinical decision-making, personalized therapy, and prognosis. We conclude by highlighting the need for more standardized methods, validation studies, and the integration of multi-domain approaches in clinical practice and research.
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Affiliation(s)
- Alessandro Scano
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), Via A. Corti 12, 20133 Milan, Italy; (C.B.); (L.M.T.)
| | - Eleonora Guanziroli
- Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy; (E.G.); (G.G.); (F.M.)
| | - Cristina Brambilla
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), Via A. Corti 12, 20133 Milan, Italy; (C.B.); (L.M.T.)
| | - Caterina Amendola
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy; (C.A.); (R.R.)
| | - Ileana Pirovano
- Institute of Biomedical Technologies (ITB), Italian National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate, Italy; (I.P.); (G.R.); (A.M.)
| | - Giulio Gasperini
- Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy; (E.G.); (G.G.); (F.M.)
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy; (E.G.); (G.G.); (F.M.)
| | - Lorenzo Spinelli
- Institute for Photonics and Nanotechnology (IFN), Italian National Research Council (CNR), Piazza Leonardo da Vinci 32, 20133 Milan, Italy;
| | - Lorenzo Molinari Tosatti
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), Via A. Corti 12, 20133 Milan, Italy; (C.B.); (L.M.T.)
| | - Giovanna Rizzo
- Institute of Biomedical Technologies (ITB), Italian National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate, Italy; (I.P.); (G.R.); (A.M.)
| | - Rebecca Re
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy; (C.A.); (R.R.)
- Institute for Photonics and Nanotechnology (IFN), Italian National Research Council (CNR), Piazza Leonardo da Vinci 32, 20133 Milan, Italy;
| | - Alfonso Mastropietro
- Institute of Biomedical Technologies (ITB), Italian National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate, Italy; (I.P.); (G.R.); (A.M.)
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Ko TS, Catennacio E, Shin SS, Stern J, Massey SL, Kilbaugh TJ, Hwang M. Advanced Neuromonitoring Modalities on the Horizon: Detection and Management of Acute Brain Injury in Children. Neurocrit Care 2023; 38:791-811. [PMID: 36949362 PMCID: PMC10241718 DOI: 10.1007/s12028-023-01690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/31/2023] [Indexed: 03/24/2023]
Abstract
Timely detection and monitoring of acute brain injury in children is essential to mitigate causes of injury and prevent secondary insults. Increasing survival in critically ill children has emphasized the importance of neuroprotective management strategies for long-term quality of life. In emergent and critical care settings, traditional neuroimaging modalities, such as computed tomography and magnetic resonance imaging (MRI), remain frontline diagnostic techniques to detect acute brain injury. Although detection of structural and anatomical abnormalities remains crucial, advanced MRI sequences assessing functional alterations in cerebral physiology provide unique diagnostic utility. Head ultrasound has emerged as a portable neuroimaging modality for point-of-care diagnosis via assessments of anatomical and perfusion abnormalities. Application of electroencephalography and near-infrared spectroscopy provides the opportunity for real-time detection and goal-directed management of neurological abnormalities at the bedside. In this review, we describe recent technological advancements in these neurodiagnostic modalities and elaborate on their current and potential utility in the detection and management of acute brain injury.
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Affiliation(s)
- Tiffany S Ko
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, USA.
| | - Eva Catennacio
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Samuel S Shin
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - Joseph Stern
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
| | - Shavonne L Massey
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Todd J Kilbaugh
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
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Dettman RW, Dizon MLV. How lung injury and therapeutic oxygen could alter white matter development. J Neurosci Res 2022; 100:2127-2137. [PMID: 33687103 PMCID: PMC8426430 DOI: 10.1002/jnr.24816] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 01/07/2023]
Abstract
Developmental brain injury describes a spectrum of neurological pathologies resulting from either antenatal or perinatal injury. This includes both cognitive and motor defects that affect patients for their entire lives. Developmental brain injury can be caused by a spectrum of conditions including stroke, perinatal hypoxia-ischemia, and intracranial hemorrhage. Additional risk factors have been identified including very low birth weight, mechanical ventilation, and oxygen (O2 ) supplementation. In fact, infants with bronchopulmonary dysplasia, an inflammatory disease associated with disrupted lung development, have been shown to have decreased cerebral white matter and decreased intracranial volumes. Thus, there appears to be a developmental link between the lung, O2 , and the brain that leads to proper myelination. Here, we will discuss what is currently known about the link between O2 and myelination and how scientists are exploring mechanisms through which supplemental O2 and/or lung injury can affect brain development. Consideration of a link between the diseased lung and developing brain will allow clinicians to fine tune their approaches in managing preterm lung disease in order to optimize brain health.
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Affiliation(s)
- Robert W. Dettman
- Perinatal Origins of Disease, Stanley Manne Children’s Research Institute, Chicago, IL 60611
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago IL, 60611
| | - Maria L. V. Dizon
- Perinatal Origins of Disease, Stanley Manne Children’s Research Institute, Chicago, IL 60611
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago IL, 60611
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Dynamics of cortical oxygenation during immediate adaptation to extrauterine life. Sci Rep 2021; 11:22041. [PMID: 34764396 PMCID: PMC8586152 DOI: 10.1038/s41598-021-01674-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022] Open
Abstract
The neonatal transition involves physiological modifications as a consequence of the complexity of the perinatal period. Various strategies can be used to attain the same level of postnatal cerebral oxygenation, depending on the status of the infant at birth. We evaluated such strategies by recording 20 full-term newborns by near-infrared spectroscopy during the first 10 min of life. The acid–base status at birth revealed two clustered profiles of cerebral oxygenation dynamics. Lower pH and base excess and higher lactate levels were associated with more rapid attainment of the 95% maximal tissue oxygenation index value. These results suggest that metabolic mechanisms drive initial cerebral oxygenation dynamics during this critical period. These results confirm the capacity of newborns to develop multiple strategies to protect the brain.
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7
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Amendola C, Spinelli L, Contini D, Carli AD, Martinelli C, Fumagalli M, Torricelli A. Accuracy of homogeneous models for photon diffusion in estimating neonatal cerebral hemodynamics by TD-NIRS. BIOMEDICAL OPTICS EXPRESS 2021; 12:1905-1921. [PMID: 33996206 PMCID: PMC8086468 DOI: 10.1364/boe.417357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
We assessed the accuracy of homogenous (semi-infinite, spherical) photon diffusion models in estimating absolute hemodynamic parameters of the neonatal brain in realistic scenarios (ischemia, hyperoxygenation, and hypoventilation) from 1.5 cm interfiber distance TD NIRS measurements. Time-point-spread-functions in 29- and 44-weeks postmenstrual age head meshes were simulated by the Monte Carlo method, convoluted with a real instrument response function, and then fitted with photon diffusion models. The results show good accuracy in retrieving brain oxygen saturation, and severe underestimation of total cerebral hemoglobin, suggesting the need for more complex models of analysis or of larger interfiber distances to precisely monitor all hemodynamic parameters.
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Affiliation(s)
| | - Lorenzo Spinelli
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Davide Contini
- Dipartimento di Fisica, Politecnico di Milano, Milan, Italy
| | - Agnese De Carli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Cesare Martinelli
- University of Milan - Department of Clinical Sciences and Community Health, Milan, Italy
| | - Monica Fumagalli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- University of Milan - Department of Clinical Sciences and Community Health, Milan, Italy
| | - Alessandro Torricelli
- Dipartimento di Fisica, Politecnico di Milano, Milan, Italy
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
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Amendola C, Lacerenza M, Buttafava M, Tosi A, Spinelli L, Contini D, Torricelli A. A Compact Multi-Distance DCS and Time Domain NIRS Hybrid System for Hemodynamic and Metabolic Measurements. SENSORS 2021; 21:s21030870. [PMID: 33525488 PMCID: PMC7866011 DOI: 10.3390/s21030870] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 01/17/2023]
Abstract
In this work, we present a new multi-distance diffuse correlation spectroscopy (DCS) device integrated with a compact state-of-the-art time domain near infrared spectroscopy (TD-NIRS) device. The hybrid DCS and TD-NIRS system allows to retrieve information on blood flow, tissue oxygenation, and oxygen metabolic rate. The DCS device performances were estimated in terms of stability, repeatability, ability in retrieving variations of diffusion coefficient, influence of the tissue optical properties, effect of varying count rates and depth sensitivity. Crosstalk between DCS and TD-NIRS optical signals was also evaluated. Finally, in vivo experiments (venous and arterial cuff occlusions on the arm) were conducted to test the ability of the hybrid system in measuring blood flow variations.
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Affiliation(s)
- Caterina Amendola
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
- Correspondence: (C.A.); (A.T.)
| | - Michele Lacerenza
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
| | - Mauro Buttafava
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, via Ponzio 34/5, 20133 Milan, Italy; (M.B.); (A.T.)
| | - Alberto Tosi
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, via Ponzio 34/5, 20133 Milan, Italy; (M.B.); (A.T.)
| | - Lorenzo Spinelli
- Consiglio Nazionale delle Ricerche, Istituto di Fotonica e Nanotecnologie, piazza Leonardo da Vinci 32, 20133 Milan, Italy;
| | - Davide Contini
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
| | - Alessandro Torricelli
- Dipartimento di Fisica, Politecnico di Milano, piazza Leonardo da Vinci 32, 20133 Milan, Italy; (M.L.); (D.C.)
- Consiglio Nazionale delle Ricerche, Istituto di Fotonica e Nanotecnologie, piazza Leonardo da Vinci 32, 20133 Milan, Italy;
- Correspondence: (C.A.); (A.T.)
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9
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Giovannella M, Andresen B, Andersen JB, El-Mahdaoui S, Contini D, Spinelli L, Torricelli A, Greisen G, Durduran T, Weigel UM, Law I. Validation of diffuse correlation spectroscopy against 15O-water PET for regional cerebral blood flow measurement in neonatal piglets. J Cereb Blood Flow Metab 2020; 40:2055-2065. [PMID: 31665953 PMCID: PMC7786848 DOI: 10.1177/0271678x19883751] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 09/06/2019] [Accepted: 09/19/2019] [Indexed: 11/15/2022]
Abstract
Diffuse correlation spectroscopy (DCS) can non-invasively and continuously asses regional cerebral blood flow (rCBF) at the cot-side by measuring a blood flow index (BFI) in non-traditional units of cm2/s. We have validated DCS against positron emission tomography using 15O-labeled water (15O-water PET) in a piglet model allowing us to derive a conversion formula for BFI to rCBF in conventional units (ml/100g/min). Neonatal piglets were continuously monitored by the BabyLux device integrating DCS and time resolved near infrared spectroscopy (TRS) while acquiring 15O-water PET scans at baseline, after injection of acetazolamide and during induced hypoxic episodes. BFI by DCS was highly correlated with rCBF (R = 0.94, p < 0.001) by PET. A scaling factor of 0.89 (limits of agreement for individual measurement: 0.56, 1.39)×109× (ml/100g/min)/(cm2/s) was used to derive baseline rCBF from baseline BFI measurements of another group of piglets and of healthy newborn infants showing an agreement with expected values. These results pave the way towards non-invasive, cot-side absolute CBF measurements by DCS on neonates.
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Affiliation(s)
- Martina Giovannella
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Bjørn Andresen
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Julie B Andersen
- Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Sahla El-Mahdaoui
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Davide Contini
- Politecnico di Milano-Dipartimento di Fisica, Milan, Italy
| | - Lorenzo Spinelli
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Alessandro Torricelli
- Politecnico di Milano-Dipartimento di Fisica, Milan, Italy
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Udo M Weigel
- HemoPhotonics S.L., Castelldefels (Barcelona), Spain
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
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