Clinical study on cerebral oxygenation state and cerebral blood flow using near infrared spectroscopy

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We have developed a new analytical system using full-spectrum near infrared spectroscopy, which allows optical spectroscopic measurements of cerebral oxy- and deoxyhemoglobin concentration, total hemoglobin, and cerebrovascular saturation. To investigate whether or not the mode of delivery produces differences in cerebral oxygenation, cerebral hemoglobin oxygen saturation was measured in 26 healthy term newborn infants immediately after birth. Infants in group 1 (n=20) were delivered vaginally, and those in group 2 (n=6) by elective cesarean section. The mean ± S.D. of cerebral hemoglobin oxygen saturation in group 1 increased rapidly afterbirth, from 29 ± 7 % at 2 min to 68 ± 6 % at 8.5 min, followed by an almost constant value (66 ± 7 % at 15 min). In comparison, cerebral hemoglobin oxygen saturation in group 2 also increased rapidly until 8.5 min, but after this time decreased significantly to 57 ± 5 % at 15 min after birth. This indicates that the mode of delivery has a marked influence on cerebral oxygenation immediately after birth.Near infrared topography with indocyanine green was used to measure regional cerebral blood flow (rCBF) in the temporal lobes of infants. The mean rCBF in infants without neural abnormality was 14.5 ± 3.1 ml/100 g/min. Moreover, in one asphyxiated infant with infarction and one infant with subdural and intracerebellar hemorrhage, it was demonstrated that the area of defective blood flow could be detected as well as it can by SPECT. This technique makes it possible to estimate rCBF distribution in infants at the bedside. Thus, in the future, evaluation of various neonatal illnesses should be feasible.