Diffuse correlation spectroscopy blood flow monitoring for intraventricular hemorrhage vulnerability in extremely low gestational age newborns.

Diffuse correlation spectroscopy blood flow monitoring for intraventricular hemorrhage vulnerability in extremely low gestational age newborns.
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DOI:
10.1038/s41598-022-16499-3
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发表时间:
2022-07-27
期刊:
影响因子:
4.6
通讯作者:
El-Dib, Mohamed
El-Dib, Mohamed
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Sunwoo, John;Zavriyev, Alexander, I;Kaya, Kutlu;Martin, Alyssa;Munster, Chelsea;Steele, Tina;Cuddyer, Deborah;Sheldon, Yvonne;Orihuela-Espina, Felipe;Herzberg, Emily M.;Inder, Terrie;Franceschini, Maria Angela;El-Dib, Mohamed

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在极低胎龄早产儿(ELGA,GA<<29周)中,脑血流(CBF)失调变化是导致生发基质/脑室内出血(GM/IVH)的主要致病因素之一。连续监测 CBF 可以指导干预措施,以尽量减少脑损伤的风险,但没有临床标准技术或工具用于其测量。我们报告了连续监测 CBF 的可行性,包括通过 ELGA 婴儿的弥散相关光谱 (DCS) 进行自动调节测量,利用 CBF 变异性和与头皮血流的相关性(SBF,作为全身扰动的替代测量)。在 19 名 ELGA 婴儿(其中 9 例 GM/IVH)中,在出生后第 2-5 天之间进行了 6-24 小时的监测,我们发现严重 IVH(III 级或 IV 级)和出生后 72 小时内诊断出的 IVH 的 CBF 和 SBF 之间存在很强的相关性,而单独的 CBF 变异性与 IVH 无关。所提出的方法在床边可能有用,可用于及时评估大脑自动调节和早期识别易受 GM/IVH 影响的婴儿。
In premature infants with an extremely low gestational age (ELGA, < 29 weeks GA), dysregulated changes in cerebral blood flow (CBF) are among the major pathogenic factors leading to germinal matrix/intraventricular hemorrhage (GM/IVH). Continuous monitoring of CBF can guide interventions to minimize the risk of brain injury, but there are no clinically standard techniques or tools for its measurement. We report the feasibility of the continuous monitoring of CBF, including measures of autoregulation, via diffuse correlation spectroscopy (DCS) in ELGA infants using CBF variability and correlation with scalp blood flow (SBF, served as a surrogate measure of systemic perturbations). In nineteen ELGA infants (with 9 cases of GM/IVH) monitored for 6–24 h between days 2–5 of life, we found a strong correlation between CBF and SBF in severe IVH (Grade III or IV) and IVH diagnosed within 72 h of life, while CBF variability alone was not associated with IVH. The proposed method is potentially useful at the bedside for the prompt assessment of cerebral autoregulation and early identification of infants vulnerable to GM/IVH.
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