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Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
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Published on: March 14, 2013

Sleep-wake cycling and cerebral oxygen metabolism among critically ill neonates

Renée A Shellhaas1, Joseph W Burns, Stephanie A Wiggins

  • 11Department of Pediatrics & Communicable Diseases, University of Michigan, Ann Arbor, MI, USA.

Journal of Child Neurology
|January 12, 2013
PubMed

Insights

Brain oxygen metabolism in critically ill newborns varies with sleep-wake states. These changes are subject-specific and may impact brain injury vulnerability in high-risk infants.

Area of Science:

  • Neonatal physiology
  • Sleep science
  • Neurocritical care

Background:

  • Adult studies show higher brain metabolism during wakefulness and REM sleep compared to non-REM sleep.
  • Data on neonatal brain metabolism across behavioral states are lacking.
  • Compromised neonatal brains may be vulnerable to hypoperfusion or hypoxia during states of higher metabolic demand.

Purpose of the Study:

  • To investigate if brain oxygen metabolism differs across sleep-wake states in critically ill newborns.
  • To assess the relationship between behavioral states and cerebral oxygenation in this population.

Main Methods:

  • Utilized cerebral oximetry (near-infrared spectroscopy) and polysomnography simultaneously.
  • Monitored sleep-wake cycling and brain oxygen metabolism in 10 critically ill infants.
  • Analyzed variations in cerebral oximetry across different behavioral states.

Main Results:

  • Sleep-wake cycling was identifiable in all infants studied.
  • Cerebral oximetry showed significant variation across behavioral states (P < .0001).
  • Observed patterns of metabolic variation were unique to each infant.

Conclusions:

  • Cerebral oxygen metabolism demonstrably varies with sleep-wake states in high-risk newborns.
  • The nature and extent of these metabolic changes are individual and variable.
  • These state-dependent metabolic fluctuations could be indicative of, or influence, brain injury and vulnerability.

Keywords:
REMnear-infrared spectroscopyneonatalpolysomnographyrapid eye movementregional oxygenationsleep

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