Abstract
BackgroundThere is a strong need for continuous cerebral circulation monitoring in neonatal care, since suboptimal cerebral blood flow may lead to brain injuries in preterm infants and other critically ill neonates. NeoDoppler is a novel ultrasound system, which can be gently fixed to the anterior fontanel and measure cerebral blood flow velocity continuously in different depths of the brain simultaneously. We aimed to study the feasibility, accuracy, and potential clinical applications of NeoDoppler in preterm infants and sick neonates.MethodTwenty-five infants born at different gestational ages with a variety of diagnoses on admission were included. The probe was placed over the anterior fontanel, and blood flow velocity data were continuously recorded. To validate NeoDoppler, we compared the measurements with conventional ultrasound; agreement was assessed using Bland–Altman plots.ResultsNeoDoppler can provide accurate and continuous data on cerebral blood flow velocity in several depths simultaneously. Limits of agreement between the measurements obtained with the two methods were acceptable.ConclusionBy monitoring the cerebral circulation continuously, increased knowledge of cerebral hemodynamics in preterm infants and sick neonates may be acquired. Improved monitoring of these vulnerable brains during a very sensitive period of brain development may contribute toward preventing brain injuries.
Highlights
IntroductionLow cerebral blood flow (CBF) and fluctuations in systemic blood flow in combination with impaired cerebral autoregulation may lead to brain injuries in preterm infants and other critically sick neonates.[1,2] These brain injuries are associated with high risk for life-long disabilities, such as cerebral palsy, mental retardation, and behavioral problems.[3,4] Currently, clinicians have to rely on indirect measurements such as assessment of cardiovascular status, including blood pressure, heart rate (HR), capillary refill, lactate, urine production, and echocardiographic measurements, to optimize CBF.[5,6] the definition of systemic hypotension and the criteria for treatment of systemic hypotension to prevent low cerebral perfusion is not clear.[5,7,8] the focus has changed during the past years from assessment of systemic blood pressure as an indicator of endorgan perfusion to directly assessing end-organ perfusion,[9] the optimal method for direct monitoring of CBF in neonates is lacking
The focus has changed during the past years from assessment of systemic blood pressure as an indicator of endorgan perfusion to directly assessing end-organ perfusion,[9] the optimal method for direct monitoring of cerebral blood flow (CBF) in neonates is lacking
Three of the preterm infants were on mechanical ventilation, and six were on noninvasive ventilatory support at the time of assessment
Summary
Low cerebral blood flow (CBF) and fluctuations in systemic blood flow in combination with impaired cerebral autoregulation may lead to brain injuries in preterm infants and other critically sick neonates.[1,2] These brain injuries are associated with high risk for life-long disabilities, such as cerebral palsy, mental retardation, and behavioral problems.[3,4] Currently, clinicians have to rely on indirect measurements such as assessment of cardiovascular status, including blood pressure, heart rate (HR), capillary refill, lactate, urine production, and echocardiographic measurements, to optimize CBF.[5,6] the definition of systemic hypotension and the criteria for treatment of systemic hypotension to prevent low cerebral perfusion is not clear.[5,7,8] the focus has changed during the past years from assessment of systemic blood pressure as an indicator of endorgan perfusion to directly assessing end-organ perfusion,[9] the optimal method for direct monitoring of CBF in neonates is lacking. There is a strong need for continuous cerebral circulation monitoring in neonatal care, since suboptimal cerebral blood flow may lead to brain injuries in preterm infants and other critically ill neonates. NeoDoppler is a novel ultrasound system, which can be gently fixed to the anterior fontanel and measure cerebral blood flow velocity continuously in different depths of the brain simultaneously. RESULTS: NeoDoppler can provide accurate and continuous data on cerebral blood flow velocity in several depths simultaneously. CONCLUSION: By monitoring the cerebral circulation continuously, increased knowledge of cerebral hemodynamics in preterm infants and sick neonates may be acquired. Improved monitoring of these vulnerable brains during a very sensitive period of brain development may contribute toward preventing brain injuries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
