Role of Optical Neuromonitoring in Neonatal Encephalopathy-Current State and Recent Advances.
Role of Optical Neuromonitoring in Neonatal Encephalopathy-Current State and Recent Advances.
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DOI：
10.3389/fped.2021.653676
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发表时间：
2021
影响因子：
2.6
通讯作者：
Mitra S
中科院分区：
文献类型：
--
作者：
Harvey-Jones K;Lange F;Tachtsidis I;Robertson NJ;Mitra S
新生儿脑病（NE）在足月和近足月婴儿是一个重要的全球性健康问题，世界范围内的疾病负担仍然很高，尽管引入治疗性低温。新生儿重症监护室（NICU）中损伤严重程度的评估和有效管理依赖于从全身到脑特异性的多种监测模式。目前的神经监测工具提供用于癫痫发作管理、损伤分层和诊断的信息，而系统监测确保及早识别多器官功能障碍并在需要时提供支持。然而，目前在NE中使用的神经监测技术在主动治疗窗口期间的可用性或在损伤后早期自信地对损伤进行分类和分层的可靠性方面存在局限性。因此，真实的需要一种神经监测工具，其提供床边、早期和连续的脑健康监测，其可以可靠地对损伤严重性进行分层，监测对当前和新兴治疗的反应，并预测结果。近红外光谱（NIRS）技术的临床应用近年来有所增加。随着仪器和信号处理技术的发展，这一人群中的研究也有所增加。NICU中越来越多地使用市售脑血氧仪，以及使用宽带NIRS（BNIRS）、频域NIRS（FDNIRS）和漫相关光谱（DCS）的先进光学测量的引入，通过允许直接监测氧代谢和脑血流来扩大范围，这两者都是了解NE病理生理变化和预测结果的关键。这篇综述讨论了光学神经监测在NE中的作用，以及为什么这种方式可能会提供下一个重要的一块拼图对理解受伤的新生儿大脑的真实的时间状态。
Neonatal encephalopathy (NE) in term and near-term infants is a significant global health problem; the worldwide burden of disease remains high despite the introduction of therapeutic hypothermia. Assessment of injury severity and effective management in the neonatal intensive care unit (NICU) relies on multiple monitoring modalities from systemic to brain-specific. Current neuromonitoring tools provide information utilized for seizure management, injury stratification, and prognostication, whilst systemic monitoring ensures multi-organ dysfunction is recognized early and supported wherever needed. The neuromonitoring technologies currently used in NE however, have limitations in either their availability during the active treatment window or their reliability to prognosticate and stratify injury confidently in the early period following insult. There is therefore a real need for a neuromonitoring tool that provides cot side, early and continuous monitoring of brain health which can reliably stratify injury severity, monitor response to current and emerging treatments, and prognosticate outcome. The clinical use of near-infrared spectroscopy (NIRS) technology has increased in recent years. Research studies within this population have also increased, alongside the development of both instrumentation and signal processing techniques. Increasing use of commercially available cerebral oximeters in the NICU, and the introduction of advanced optical measurements using broadband NIRS (BNIRS), frequency domain NIRS (FDNIRS), and diffuse correlation spectroscopy (DCS) have widened the scope by allowing the direct monitoring of oxygen metabolism and cerebral blood flow, both key to understanding pathophysiological changes and predicting outcome in NE. This review discusses the role of optical neuromonitoring in NE and why this modality may provide the next significant piece of the puzzle toward understanding the real time state of the injured newborn brain.
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影响因子：
2.6
作者：
Dix LM;van Bel F;Lemmers PM
通讯作者：
Lemmers PM
影响因子：
5.7
作者：
Bainbridge A;Tachtsidis I;Faulkner SD;Price D;Zhu T;Baer E;Broad KD;Thomas DL;Cady EB;Robertson NJ;Golay X
通讯作者：
Golay X
影响因子：
4.8
作者：
du Plessis, AJ;Volpe, JJ
通讯作者：
Volpe, JJ
影响因子：
3.4
作者：
Diop M;Verdecchia K;Lee TY;St Lawrence K
通讯作者：
St Lawrence K
影响因子：
6.3
作者：
Dehaes, Mathieu;Aggarwal, Alpna;Grant, P. Ellen
通讯作者：
Grant, P. Ellen