title: Perioperative cerebral hemodynamics and oxygen metabolism in neonates with single-ventricle physiology.
abstract: Congenital heart disease (CHD) patients are at risk for neurodevelopmental delay. The etiology of these delays is unclear, but abnormal prenatal cerebral maturation and postoperative hemodynamic instability likely play a role. A better understanding of these factors is needed to improve neurodevelopmental outcome. In this study, we used bedside frequency-domain near infrared spectroscopy (FDNIRS) and diffuse correlation spectroscopy (DCS) to assess cerebral hemodynamics and oxygen metabolism in neonates with single-ventricle (SV) CHD undergoing surgery and compared them to controls. Our goals were 1) to compare cerebral hemodynamics between unanesthetized SV and healthy neonates, and 2) to determine if FDNIRS-DCS could detect alterations in cerebral hemodynamics beyond cerebral hemoglobin oxygen saturation (SO 2). Eleven SV neonates were recruited and compared to 13 controls. Preoperatively, SV patients showed decreased cerebral blood flow (CBFi ), cerebral oxygen metabolism (CMRO 2i ) and SO 2; and increased oxygen extraction fraction (OEF) compared to controls. Compared to preoperative values, unstable postoperative SV patients had decreased CMRO 2i and CBFi , which returned to baseline when stable. However, SO 2 showed no difference between unstable and stable states. Preoperative SV neonates are flow-limited and show signs of impaired cerebral development compared to controls. FDNIRS-DCS shows potential to improve assessment of cerebral development and postoperative hemodynamics compared to SO 2 alone.
authors.affiliation: Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA ; Mathieu Dehaes is currently at University of Montréal and Centre Hospitalier Universitaire Sainte-Justine, Montréal (QC), H3T 1C5, Canada ; Mathieu Dehaes and Henry H. Cheng contributed equally to this work ; mathieu.dehaes@umontreal.ca.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Dehaes
authors.affiliation: Department of Cardiology, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA ; Mathieu Dehaes and Henry H. Cheng contributed equally to this work.
authors.forename: Henry H
authors.initials: HH
authors.lastname: Cheng
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital & Harvard Medical School, Charlestown, MA 02129, USA ; Erin M. Buckley is currently at Georgia Institute of Technology, Atlanta, GA 30322, USA.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Buckley
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital & Harvard Medical School, Charlestown, MA 02129, USA.
authors.forename: Pei-Yi
authors.initials: PY
authors.lastname: Lin
authors.affiliation: Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Silvina
authors.initials: S
authors.lastname: Ferradal
authors.affiliation: Department of Cardiology, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Williams
authors.affiliation: Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Rutvi
authors.initials: R
authors.lastname: Vyas
authors.affiliation: Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Hagan
authors.affiliation: Department of Cardiology, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wigmore
authors.affiliation: Department of Cardiology, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: McDavitt
authors.affiliation: Department of Neurology, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Janet S
authors.initials: JS
authors.lastname: Soul
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital & Harvard Medical School, Charlestown, MA 02129, USA.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Franceschini
authors.affiliation: Department of Cardiology, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Jane W
authors.initials: JW
authors.lastname: Newburger
authors.affiliation: Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital & Harvard Medical School, Boston, MA 02115, USA.
authors.forename: P
authors.initials: P
authors.lastname: Ellen Grant
keywords: (170.0170) Medical optics and biotechnology; (170.3880) Medical and biological imaging; (170.5380) Physiology