Continuous quantitative monitoring of cerebral oxygen metabolism in neonates by ventilator-gated analysis of NIRS recordings

Oxidative stress during fetal development, delivery, or early postnatal life is a major cause of neuropathology, as both hypoxic and hyperoxic insults can significantly damage the developing brain. Despite the obvious need for reliable cerebral oxygenation monitoring, no technology currently exists...

詳細記述

書誌詳細
主要な著者: Heldt, Thomas, Kashif, Faisal Mahmood, Verghese, George C., Sulemanji, Mustafa, O'Leary, Heather M., Plessis, Adré J. du
その他の著者: Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
フォーマット: 論文
言語:en_US
出版事項: Springer-Verlag 2012
オンライン・アクセス:http://hdl.handle.net/1721.1/73585
https://orcid.org/0000-0002-5930-7694
https://orcid.org/0000-0002-2446-1499
その他の書誌記述
要約:Oxidative stress during fetal development, delivery, or early postnatal life is a major cause of neuropathology, as both hypoxic and hyperoxic insults can significantly damage the developing brain. Despite the obvious need for reliable cerebral oxygenation monitoring, no technology currently exists to monitor cerebral oxygen metabolism continuously and noninvasively in infants at high risk for developing brain injury. Consequently, a rational approach to titrating oxygen supply to cerebral oxygen demand – and thus avoiding hyperoxic or hypoxic insults – is currently lacking. We present a promising method to close this crucial technology gap in the important case of neonates on conventional ventilators. By using cerebral near-infrared spectroscopy and signals from conventional ventilators, along with arterial oxygen saturation, we derive continuous (breath-by-breath) estimates of cerebral venous oxygen saturation, cerebral oxygen extraction fraction, cerebral blood flow, and cerebral metabolic rate of oxygen. The resultant estimates compare very favorably to previously reported data obtained by non-continuous and invasive means from preterm infants in neonatal critical care.