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Updated: Jun 23, 2025
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Instant Detection of Cerebral Blood Flow Changes in Infants with Congenital Heart Disease during Transcatheter
Martin Leth-Olsen1,2, Gaute Døhlen3, Hans Torp1
1Department of Circulation and Medical Imaging (ISB), Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7030 Trondheim, Norway.
Insights
Continuous transfontanellar cerebral Doppler monitoring effectively tracks cerebral blood flow changes during transcatheter interventions in infants with congenital heart disease, aiding in complication detection.
Area of Science:
- Pediatric Cardiology
- Medical Devices
- Cerebral Hemodynamics
Background:
- Transcatheter interventions are common for congenital heart disease in children.
- These procedures can impact cardiac output and cerebral blood flow.
- A need exists for real-time monitoring of cerebral circulation during these interventions.
Purpose of the Study:
- To evaluate the feasibility and utility of the NeoDoppler system for continuous transfontanellar cerebral Doppler monitoring.
- To assess the impact of transcatheter interventions on cerebral hemodynamics in infants.
- To determine if NeoDoppler can detect changes related to interventions and complications.
Main Methods:
- Prospective pilot study including 19 infants (<1 year) undergoing transcatheter cardiac interventions.
- Continuous transfontanellar cerebral Doppler monitoring using NeoDoppler initiated post-intubation.
- Monitoring continued throughout the intervention procedure.
Main Results:
- NeoDoppler detected instantaneous changes in cerebral blood flow during various interventions.
- Specific changes noted during balloon aortic valvuloplasty and patent ductus arteriosus occlusion.
- Cerebral blood flow pattern changes were identified in two patients with complications.
- High-quality recordings achieved in 87.3% of the monitoring time.
Conclusions:
- Continuous transfontanellar cerebral Doppler monitoring is feasible in infants undergoing transcatheter interventions.
- The NeoDoppler system can monitor cerebral hemodynamic trends and detect immediate changes.
- This technology shows potential as a valuable tool for intraprocedural monitoring in pediatric cardiac interventions.
Abstract:
Background: Transcatheter interventions are increasingly used in children with congenital heart disease. However, these interventions can affect cardiac output and cerebral circulation. In this pilot study, we aimed to investigate the use of NeoDoppler, a continuous transfontanellar cerebral Doppler monitoring system, to evaluate the impact of transcatheter interventions on cerebral circulation. Methods: Nineteen participants under one year of age (mean age 3.5 months) undergoing transcatheter cardiac interventions were prospectively included. Transfontanellar cerebral Doppler monitoring with the NeoDoppler system was initiated after intubation and continued until the end of the procedure. Results: Instant detection of changes in cerebral blood flow were observed across a spectrum of transcatheter interventions. Balloon aortic valvuloplasty demonstrated temporary cessation of cerebral blood flow during balloon inflation. Increase in cerebral diastolic blood flow velocity and decreased pulsatility were observed during patent ductus arteriosus occlusion. Changes in cerebral blood flow patterns were detected in two patients who encountered complications during their transcatheter interventions. There was no significant change in Doppler parameters before and after the interventions for the entire patient group. High quality recordings were achieved in 87.3% of the monitoring period. Conclusions: Continuous transfontanellar cerebral Doppler is feasible in monitoring cerebral hemodynamic trends and shows instantaneous changes associated with interventions and complications. It could become a useful monitoring tool during transcatheter interventions in infants.
