Role of Near-Infrared Spectroscopy in Monitoring the Clinical Course of Asphyxiated Neonates Treated with Hypothermia

2021 ◽  
Author(s):  
Marwa Mohamed Farag ◽  
Ahmed Abd El-Halim Abd El-Raziq Khedr ◽  
MennattAllah Hassan Attia ◽  
Hesham Abd EL-Rahim Ghazal
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Neonatal Intensive Care ◽  
Near Infrared ◽  
Clinical Course ◽  
Birth Asphyxia ◽  
Maternity Hospital ◽  
Key Points ◽  
Near Term ◽  
Magnetic Resonance Imaging Mri

Objective Hypoxic-ischemic encephalopathy (HIE) affects millions of newborns annually, especially in low-resource settings. Real-time monitoring of hypoxic-ischemic brain damage is urgently needed for assessment of severity and management of neonates with birth asphyxia. Aim of the work is monitoring of near-infrared spectroscopy (NIRS)-measured cerebral regional oxygen saturation (cRSO2) and cerebral fractional tissue oxygen extraction (FTOE) in neonates after birth asphyxia in relation to their clinical course. Study Design Forty asphyxiated-term and near-term neonates with mild to severe HIE admitted at neonatal intensive care unit of Alexandria University Maternity Hospital from March to October 2019, received therapeutic hypothermia (TH) and had continuous NIRS monitoring of cRSO2 for 72 hours. Infants were categorized into HIE with seizing and nonseizing groups, and abnormal and normal magnetic resonance imaging (MRI) groups. Results Clinical seizures (CS) occurred in 15 (37.5%) of HIE neonates and 13.3% of them died (n = 2). In the current study, significantly higher cRSO2 and lower FTOE values were found in the seizing infants as compared with nonseizing group (p < 0.001). NIRS-measured day 2-cRSO2 and day 1-FTOE were associated with CS in newborns with HIE and day 1-cRSO2 and FTOE were associated with abnormal MRI at 1 month of age. cRSO2 values were found to correlate positively with initial Thompson score especially in days 1 and 2. Further, neonates with CS were more likely to have MRI abnormalities at follow-up. Conclusion NIRS measures may highlight differences between asphyxiated neonates who develop CS or later MRI abnormalities and those who do not. Key Points

scholarly journals Near-infrared spectroscopy measurements of cerebral blood flow and oxygen consumption following hypoxia-ischemia in newborn piglets

2006 ◽  
Vol 100 (3) ◽  
pp. 850-857 ◽  
Author(s):  
Kenneth M. Tichauer ◽  
Derek W. Brown ◽  
Jennifer Hadway ◽  
Ting-Yim Lee ◽  
Keith St. Lawrence
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Neonatal Intensive Care ◽  
Near Infrared ◽  
Hemoglobin Concentration ◽  
Oxygen Extraction Fraction ◽  
Newborn Piglets ◽  
Hypoxia Ischemia

Impaired oxidative metabolism following hypoxia-ischemia (HI) is believed to be an early indicator of delayed brain injury. The cerebral metabolic rate of oxygen (CMRO2) can be measured by combining near-infrared spectroscopy (NIRS) measurements of cerebral blood flow (CBF) and cerebral deoxy-hemoglobin concentration. The ability of NIRS to measure changes in CMRO2 following HI was investigated in newborn piglets. Nine piglets were subjected to 30 min of HI by occluding both carotid arteries and reducing the fraction of inspired oxygen to 8%. An additional nine piglets served as sham-operated controls. Measurements of CBF, oxygen extraction fraction (OEF), and CMRO2 were obtained at baseline and at 6 h after the HI insult. Of the three parameters, only CMRO2 showed a persistent and significant change after HI. Five minutes after reoxygenation, there was a 28 ± 12% (mean ± SE) decrease in CMRO2, a 72 ± 50% increase in CBF, and a 56 ± 19% decrease in OEF compared with baseline ( P < 0.05). By 30 min postinsult and for the remainder of the study, there were no significant differences in CBF and OEF between control and insult groups, whereas CMRO2 remained depressed throughout the 6-h postinsult period. This study demonstrates that NIRS can measure decreases in CMRO2 caused by HI. The results highlight the potential for NIRS to be used in the neonatal intensive care unit to detect delayed brain damage.

scholarly journals Near-Infrared Spectroscopy in Extremely Preterm Infants

2021 ◽  
Vol 8 ◽  
Author(s):  
Leeann R. Pavlek ◽  
Clifford Mueller ◽  
Maria R. Jebbia ◽  
Matthew J. Kielt ◽  
Omid Fathi
Keyword(s):  
Infrared Spectroscopy ◽  
Preterm Infants ◽  
Near Infrared Spectroscopy ◽  
Neonatal Intensive Care ◽  
Near Infrared ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Potential Applications

With advances in neonatal care, survival of premature infants at the limits of viability has improved significantly. Despite these improvement in mortality, infants born at 22–24 weeks gestation are at a very high risk for short- and long-term morbidities associated with prematurity. Many of these diseases have been attributed to abnormalities of tissue oxygenation and perfusion. Near-infrared spectroscopy utilizes the unique absorption properties of oxyhemoglobin and deoxyhemoglobin to provide an assessment of regional tissue oxygen saturation, which can be used to calculate the fractional tissue oxygen extraction. This allows for a non-invasive way to monitor tissue oxygen consumption and enables targeted hemodynamic management. This mini-review provides a brief and complete overview of the background and physiology of near-infrared spectroscopy, practical use in extremely preterm infants, and potential applications in the neonatal intensive care unit. In this mini-review, we aim to summarize the three primary application sites for near-infrared spectroscopy, disease-specific indications, and available literature regarding use in extremely preterm infants.

Cerebral oxygen supply during hypotension in near-term lambs: A near-infrared spectroscopy study

2006 ◽  
Vol 28 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Sandra Van Os ◽  
John Klaessens ◽  
Jeroen Hopman ◽  
Djien Liem ◽  
Margot Van De Bor
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Oxygen Supply ◽  
Near Infrared ◽  
Cerebral Oxygen ◽  
Spectroscopy Study ◽  
Near Term

scholarly journals Indexing cerebrovascular health using near-infrared spectroscopy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rashid Afkhami ◽  
Frederick R. Walker ◽  
Saadallah Ramadan ◽  
Rachel Wong ◽  
Sarah J. Johnson
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Augmentation Index ◽  
New Technology ◽  
Early Results ◽  
Cerebrovascular Health ◽  
Magnetic Resonance Imaging Mri ◽  
Tracking Device ◽  
Relationship Of

AbstractNear-infrared spectroscopy (NiRS) is a relatively new technology of brain imaging with its potential in the assessment of cerebrovascular health only recently discovered. Encouraging early results suggest that NiRS can be used as an inexpensive and portable cerebrovascular health tracking device using a recently proposed pulse relaxation function (PReFx). In this paper, we propose a new NiRS timing index, $$\text {TI}_{\rm NiRS}$$ TI NiRS , of cerebrovascular health. $$\text {TI}_{\rm NiRS}$$ TI NiRS is a novel use of the NiRS technology. $$\text {TI}_{\rm NiRS}$$ TI NiRS is motivated by the previously proved relationship of the timing of the reflected wave with vascular resistance and compliance in the context of pressure waveforms. We correlated both $$\text {TI}_{\rm NiRS}$$ TI NiRS and PReFx against age, a non-exercise cardiorespiratory fitness (CRF) index, and two existing indices of cerebrovascular health, namely transcranial Doppler (TCD) augmentation index, $$\text {AI}_{\rm TCD}$$ AI TCD , and magnetic resonance imaging (MRI) blood flow pulsatility index, $$\text {PI}_{\rm MRI}$$ PI MRI . The $$\text {TI}_{\rm NiRS}$$ TI NiRS correlations with Age, CRF, $$\text {PI}_{\rm MRI}$$ PI MRI and $$\text {AI}_{\rm TCD}$$ AI TCD all are significant, i.e., $$r=0.53$$ r = 0.53 ($$p=0.002$$ p = 0.002 ), $$r=-0.44$$ r = - 0.44 ($$p=0.011$$ p = 0.011 ), $$r=0.45$$ r = 0.45 ($$p=0.012$$ p = 0.012 ) and $$r=0.46$$ r = 0.46 ($$p=0.010$$ p = 0.010 ), respectively. PReFx, however, did not have significant correlations with any of the vascular health factors. The proposed timing index is a reliable indicator of cerebrovascular aging factors in the NiRS waveform.

Brain Cell Function during Hypoxemia in Near-Term Lambs: A Near-Infrared Spectroscopy Study

Neonatology ◽  
2005 ◽  
Vol 88 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Sandra van Os ◽  
John Klaessens ◽  
Jeroen Hopman ◽  
Djien Liem ◽  
Margot van de Bor
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cell Function ◽  
Brain Cell ◽  
Spectroscopy Study ◽  
Near Term

scholarly journals Indexing Cerebrovascular Health Using Near-infrared Spectroscopy

2021 ◽  
Author(s):  
Rashid Afkhami ◽  
Frederick Rohan Walker ◽  
Saadallah Ramadan ◽  
Rachel Wong ◽  
Sarah Johnson
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Augmentation Index ◽  
New Technology ◽  
Early Results ◽  
Cerebrovascular Health ◽  
Magnetic Resonance Imaging Mri ◽  
Tracking Device ◽  
Relationship Of

Near-infrared spectroscopy (NiRS) is a relatively new technology of brain imaging with its potential in the assessment of cerebrovascular health only recently discovered. Encouraging early results suggest that NiRS can be used as an inexpensive and portable cerebrovascular health tracking device using a recently proposed pulse relaxation function (PReFx). In this paper, we propose a new NiRS timing index, TI-NiRS, of cerebrovascular health. TI-NiRS is a novel use of the NiRS technology. TI-NiRS is motivated by the previously proved relationship of the timing of the reflected wave with vascular resistance and compliance in the context of pressure waveforms. We correlated both TI-NiRS and PReFx against age, a non-exercise cardiorespiratory fitness (CRF) index, and two existing indices of cerebrovascular health, namely Transcranial Doppler (TCD) augmentation index, AI-TCD, and magnetic resonance imaging (MRI) blood flow pulsatility index, PI-MRI. The TI-NiRS correlations with Age, CRF, PI-MRI and AI-TCD all are significant, i.e., r = 0.53 (p = 0.002), r = 0.44 (p = 0.011), r = 0.45 (p = 0.012) and r = 0.46 (p = 0.010), respectively. PReFx, however, did not have significant correlations with any of the vascular health factors. The proposed timing index is a reliable indicator of cerebrovascular aging factors in the NiRS waveform.

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