Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage

• Published in: Scientific reports 2016-05, Vol.6 (1), p.25903-25903, Article 25903
• Main Authors: Lin, Pei-Yi, Hagan, Katherine, Fenoglio, Angela, Grant, P. Ellen, Franceschini, Maria Angela
• Format: Article
• Language: English
• Subjects: 639/624/1107/527/1989; 692/308/3187; 692/53/2422; 692/699/375/1345/3195; Brain - blood supply; Cerebral Intraventricular Hemorrhage - diagnostic imaging; Cerebral Intraventricular Hemorrhage - metabolism; Cerebrovascular Circulation; Female; Gestational Age; Humanities and Social Sciences; Humans; Infant; Infant, Extremely Premature - metabolism; Infant, Newborn; Infant, Premature, Diseases - diagnostic imaging; Infant, Premature, Diseases - metabolism; Male; Monitoring, Physiologic; multidisciplinary; Oxygen - metabolism; Science; Spectroscopy, Near-Infrared
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep25903

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 (SO 2 ) and an index of cerebral blood flow (CBF i ) at the infant’s bedside and compute an index of cerebral oxygen metabolism (CMRO 2i ). 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 CBF i and CMRO 2i in ELGA neonates with low-grade GM-IVH compared to neonates without hemorrhages. Furthermore, lower CBF i and CMRO 2i in the former group persists even after the resolution of the hemorrhage. In contrast, SO 2 does not differ between groups. Thus, CBF i and CMRO 2i may have better sensitivity than SO 2 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.