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

我们开发了一种新的分析系统，使用全光谱近红外光谱，可以用光学光谱测量脑氧合和脱氧血红蛋白浓度、总血红蛋白和脑血管饱和度。为探讨不同分娩方式对脑氧合的影响，对26例健康足月新生儿出生后即刻进行脑血氧饱和度测定。第1组(n=20)经阴道分娩，第2组(n=6)择期剖宫产。组1脑血氧饱和度的平均值在出生后迅速升高，从2min的29±7%上升到8.5min的68±6%，然后基本持平(15min时为66±7%)。而脑血红蛋白血氧饱和度在出生后8.5min也迅速升高，但此后显著下降至出生后15min的57±5%。这表明分娩方式对出生后即刻的脑氧合有显著影响。应用吲哚青绿近红外地形图测量婴儿颞叶局部脑血流量(RCBF)。无神经异常者平均rCBF为14.5±3.1ml/100g/min。此外，对1例窒息脑梗塞和1例硬膜下及小脑内出血的婴儿，SPECT也能检测到血流缺损区。这项技术使得在床边估计婴儿的rCBF分布成为可能。因此，在未来，评估各种新生儿疾病应该是可行的。

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.