Research on pathophysiology and prevention of neonatal ischemic brain damage using near infrared spectroscopy

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We investigated the effect of indomethacin and hyperventilation on cerebral hemodynamics and oxygenation in newborn piglets using near infrared spectroscopy (NIRS). The piglets were divided into 2 groups. Indomethacin (Experimental group ; 0.2 mg/kg IV) or saline was administered after steady state, then each group was hyperventilated (pCO_2 ; 20 mm Hg). Cerebral oxyhemoglobin (Hb O_2) decreased immediately after indomethacin treatment compared to controls. This decrease continued for 15 minutes. During hyperventilation, Hb O_2 remained low compared to steady state in the experimental group. Total hemoglobin (Hb T) decreased simultaneously with Hb O_2. In the control group, no changes in Hb O_2 or Hb T were observed after saline administration, and only a slight decrease in Hb O_2 during the 5 minutes hyperventilation compared to steady state. No changes in cytochrome aa3 was observed in either group during 100% O_2 inhalation. We conclude that indomathacin decreased Hb O_2 and Hb T by vasoconstriction but that hyperventilation did not further aggravate this tendency. Great care should be taken when using indomethacin for newborn neonates. Using NIRS, we also investigated cerebral hemodynamics and oxygenation of neonates during exchange transfusion and of Rett patients with breathing abnormalities. NIRS provided useful information about cerebral hemodynamics and oxygenation in neonates and children. Monitoring specific patterns by NIRS may be useful for preventing brain damage.