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Updated: Dec 14, 2025
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Perfusion and Metabolic Neuromonitoring during Ventricular Taps in Infants with Post-Hemorrhagic Ventricular
Ajay Rajaram1,2, Lawrence C M Yip1,2, Daniel Milej1,2
1Imaging Program, Lawson Health Research Institute, London, ON N6A 4V2, Canada.
Insights
This study introduces the Neonatal NeuroMonitor (NNeMo) for assessing brain blood flow and metabolism in infants with post-hemorrhagic ventricular dilatation. The device showed potential for safe, non-invasive neuromonitoring, though results on intervention effects were subtle.
Area of Science:
- Biomedical Engineering
- Neonatal Neurology
- Medical Devices
Background:
- Post-hemorrhagic ventricular dilatation (PHVD) in neonates increases intracranial pressure, necessitating interventions like ventricular taps (VT).
- The optimal timing for VT remains challenging due to imprecise monitoring of neonatal cerebral hemodynamics and metabolism.
- Current monitoring methods may not provide real-time, comprehensive data on cerebral blood flow and tissue oxygenation.
Purpose of the Study:
- To present and evaluate the Neonatal NeuroMonitor (NNeMo), a novel portable optical device for simultaneous neuromonitoring.
- To assess the feasibility of NNeMo in measuring cerebral blood flow (CBF), tissue saturation (StO2), and cytochrome c oxidase oxidation state (oxCCO) in PHVD patients.
- To investigate the impact of ventricular taps on cerebral hemodynamics and metabolism using NNeMo.
Main Methods:
- Developed and utilized the Neonatal NeuroMonitor (NNeMo), integrating broadband near-infrared spectroscopy (B-NIRS) and diffuse correlation spectroscopy (DCS).
- Monitored CBF, StO2, and oxCCO in four neonatal intensive care unit patients with PHVD undergoing ventricular taps.
- Analyzed physiological data before and after multiple VTs, including outlier removal for sensitivity analysis.
Main Results:
- NNeMo provided safe, non-invasive measurements of cerebral perfusion and metabolism in PHVD patients.
- No significant changes in CBF, StO2, or oxCCO were observed across multiple VTs when analyzing all data.
- Removing outliers revealed small, statistically significant increases in CBF and oxCCO post-intervention, suggesting subtle hemodynamic/metabolic responses.
Conclusions:
- The Neonatal NeuroMonitor (NNeMo) is a promising tool for real-time, non-invasive neuromonitoring in the NICU.
- NNeMo can assess cerebral hemodynamics and metabolism in neonates with PHVD, aiding in the understanding of interventions.
- Further research is warranted to refine outlier detection and fully elucidate the clinical utility of NNeMo in optimizing PHVD management.
Abstract:
Post-hemorrhagic ventricular dilatation (PHVD) is characterized by a build-up of cerebral spinal fluid (CSF) in the ventricles, which increases intracranial pressure and compresses brain tissue. Clinical interventions (i.e., ventricular taps, VT) work to mitigate these complications through CSF drainage; however, the timing of these procedures remains imprecise. This study presents Neonatal NeuroMonitor (NNeMo), a portable optical device that combines broadband near-infrared spectroscopy (B-NIRS) and diffuse correlation spectroscopy (DCS) to provide simultaneous assessments of cerebral blood flow (CBF), tissue saturation (StO2), and the oxidation state of cytochrome c oxidase (oxCCO). In this study, NNeMo was used to monitor cerebral hemodynamics and metabolism in PHVD patients selected for a VT. Across multiple VTs in four patients, no significant changes were found in any of the three parameters: CBF increased by 14.6 ± 37.6% (p = 0.09), StO2 by 1.9 ± 4.9% (p = 0.2), and oxCCO by 0.4 ± 0.6 µM (p = 0.09). However, removing outliers resulted in significant, but small, increases in CBF (6.0 ± 7.7%) and oxCCO (0.1 ± 0.1 µM). The results of this study demonstrate NNeMo's ability to provide safe, non-invasive measurements of cerebral perfusion and metabolism for neuromonitoring applications in the neonatal intensive care unit.
