In Canada, 8% of births occur prematurely. Preterm infants weighing less than 1500g are at a high risk of neurodevelopmental impairment: 5-10% develop major disabilities such as cerebral palsy and 40-50% show other cognitive and behavioural deficits. The brain is vulnerable to periods of low cerebral blood flow (CBF) that can impair energy metabolism and cause tissue damage. There is, therefore, a need for an efficient neuromonitoring system to alert the neonatal intensive care team to clinically significant changes in CBF and metabolism, before injury occurs.
Optical technologies offer safe, non-invasive, and cost-effective methods for neuromonitoring. Cerebral oxygen saturation (ScO2) can be measured by exploiting the absorption properties of hemoglobin though Near-Infrared Spectroscopy (NIRS), and Diffuse Correlation Spectroscopy (DCS) can monitor CBF by tracking red blood cells. These measures can be combined to describe metabolism, a key indicator of tissue viability.
In this study we present the development and testing of a hybrid broadband NIRS/DCS neuromonitor. This system is novel in its ability to simultaneously acquire broadband NIRS and DCS signals, providing a truly real-time measure of metabolism. Narrow bandpass and notch filters have been incorporated to diminish light contamination between the two modalities, preferentially filtering out each source from the opposing detector, allowing for an accurate measure of ScO2, CBF, and metabolism. With a broadband NIRS/DCS system, a real-time measure of CBF and metabolism within the developing brain can aid clinicians in monitoring events that precede brain injury, ultimately leading to better clinical outcomes.