Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage.
Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage.
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DOI：
10.1038/srep25903
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发表时间：
2016-05-16
影响因子：
4.6
通讯作者：
Franceschini MA
中科院分区：
文献类型：
--
作者：
Lin PY;Hagan K;Fenoglio A;Grant PE;Franceschini MA
轻度脑室内出血（GM-IVH）是极早产儿最常见的并发症。GM-IVH的发生与早产儿脑血流动力学不稳定密切相关，但低度GM-IVH对脑血流和神经元健康的长期影响尚未得到充分研究。我们使用频域近红外光谱和扩散相关光谱（FDNIRS-DCS）的创新组合来测量婴儿床边的脑氧饱和度（SO2）和脑血流量指数（CBFi），并计算脑氧代谢指数（CMRO 2 i）。我们招募了20名极低胎龄（ELGA）新生儿（7名患有低度GM-IVH），每周监测一次，直到他们达到足月等效年龄。在他们住院期间，我们观察到ELGA新生儿与低级别GM-IVH相比，CBFi和CMRO 2 i始终较低。此外，即使在出血消退后，前一组中的较低CBFi和CMRO 2 i仍持续存在。相比之下，SO2在各组之间没有差异。因此，CBFi和CMRO 2 i在检测GM-IVH对婴儿大脑发育的相关影响方面可能比SO2具有更好的灵敏度。FDNIRS-DCS方法可能对监测GM-IVH的演变、评估治疗反应和潜在地预测神经发育结果具有临床益处。
Low-grade germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common complication in extremely premature neonates. The occurrence of GM-IVH is highly associated with hemodynamic instability in the premature brain, yet the long-term impact of low-grade GM-IVH on cerebral blood flow and neuronal health have not been fully investigated. We used an innovative combination of frequency-domain near infrared spectroscopy and diffuse correlation spectroscopy (FDNIRS-DCS) to measure cerebral oxygen saturation (SO2) and an index of cerebral blood flow (CBFi) at the infant’s bedside and compute an index of cerebral oxygen metabolism (CMRO2i). We enrolled twenty extremely low gestational age (ELGA) neonates (seven with low-grade GM-IVH) and monitored them weekly until they reached full-term equivalent age. During their hospital stay, we observed consistently lower CBFi and CMRO2i in ELGA neonates with low-grade GM-IVH compared to neonates without hemorrhages. Furthermore, lower CBFi and CMRO2i in the former group persists even after the resolution of the hemorrhage. In contrast, SO2 does not differ between groups. Thus, CBFi and CMRO2i may have better sensitivity than SO2 in detecting GM-IVH-related effects on infant brain development. FDNIRS-DCS methods may have clinical benefit for monitoring the evolution of GM-IVH, evaluating treatment response, and potentially predicting neurodevelopmental outcome.