Abstract
The purpose of this study was to explore whether quantitative indices of cerebral oxygenation could be obtained in infants by near infrared spectrophotometry. Portable apparatus was designed and built so that near infrared light emitted by laser diodes at four different wave lengths could be directed into the head through fibre optic bundles and collected on the other side. Changes in near infrared absorption were analysed, using algorithms derived from studies on fluorocarbon exchange transfused rats, to give signals proportional to the concentrations of haemoglobin (Hb), oxy-haemoglobin (HbO2) and oxidised cyto-chrome a, a3 in the light-path. Changes in cerebral blood volume were estimated from the sum of the Hb and HbO2 signals. All the indices were displayed at the cot-side. Ten preterm and term infants were studied for periods of one to six hours. Highly significant and reproducible changes in cerebral oxygenation and blood volume were observed in response to alterations in arterial oxygen and carbon dioxide tensions, to tilting head up and head down, and following the administration of indomethacin. Marked differences in the indices were detected between normal infants and some infants with cerebral disorders. Near infrared spectrophotometry is a practical non-invasive technique that gives valuable information about cerebral oxygenation and blood volume in sick newborn infants.
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