In premature infants with an extremely low gestational age (ELGA, < 29 weeks GA), dysregulated changes in cerebral blood flow (CBF) are among the major pathogenic factors leading to germinal matrix/intraventricular hemorrhage (GM/IVH). Continuous monitoring of CBF can guide interventions to minimize the risk of brain injury, but there are no clinically standard techniques or tools for its measurement. We report the feasibility of the continuous monitoring of CBF, including measures of autoregulation, via diffuse correlation spectroscopy (DCS) in ELGA infants using CBF variability and correlation with scalp blood flow (SBF, served as a surrogate measure of systemic perturbations). In nineteen ELGA infants (with 9 cases of GM/IVH) monitored for 6-24 h between days 2-5 of life, we found a strong correlation between CBF and SBF in severe IVH (Grade III or IV) and IVH diagnosed within 72 h of life, while CBF variability alone was not associated with IVH. The proposed method is potentially useful at the bedside for the prompt assessment of cerebral autoregulation and early identification of infants vulnerable to GM/IVH.
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The authors would like to thank Zachary Starkweather and Adriano Peruch for building DCS sensors, Vidhya Vijayakrishnan Nair and Parya Farzam for pilot data acquisition, Natascha Lawrence and Elizabeth Singh for patient recruitment, Sarah Lee for data handling and patient recruitment, Yujing Huang for DCS graphical-user-interface, and Drs. Nisan Ozana, Marco Renna, and Rahul Pal for helpful discussion. This work was supported by National Institutes of Health Grant R01HD091067.
© 2022, The Author(s).