Session: Neonatal Cardiology and Pulmonary Hypertension Works in Progress
WIP 170 - Diffuse correlation spectroscopy vs transcranial doppler ultrasound in the monitoring of cerebral blood flow in patients with congenital heart defects
Fellow Baylor College of Medicine Houston, Texas, United States
Background: There is a high prevalence of peri-operative brain injury and neurodevelopmental impairments in neonates with congenital heart disease (CHD). Transcranial Doppler ultrasound (TCD) is a standard, non-invasive method to monitor neonatal cerebral blood flow (CBF ) in the middle cerebral artery. Unfortunately, TCD is technically challenging to deploy and requires nearly constant attention during use. Diffuse correlation spectroscopy (DCS) employs near-infrared light and detects changes in CBF directly by monitoring temporal fluctuations of scattered light. It can be utilized continuously and provide information about microvascular hemodynamics. Objective: This is a validation study to compare measurements of DCS and TCD in the monitoring of CBF in patients who require intervention for congenital heart defects pre and post-surgical intervention. It will aid in the prevention of brain injury in the neonatal population by improving the assessment of cerebral perfusion and improve our understanding of vascular auto-regulation. Design/Methods: All neonates with heart defects requiring surgical repair admitted to the ICU at Texas Children's Hospital from January 2023 to March 2024 are eligible for this study. We have approval from the Baylor College of Medicine IRB to conduct this observational study (# H-41489). Ten-minute TDC and DCS measurements will be taken synchronously on the neonate's forehead. Measures will occur within 120 hours before and 120 hours after the corrective intervention. The middle cerebral artery blood flow velocity will be recorded by TCD ultrasound. Microvascular blood flow of the cerebral cortex will be measured with DCS. Digitized files will be subsequently analyzed using MATLAB. Comparisons of blood flow index (BFI) and ultrasound blood velocity will be made using linear regression. We will use our data to identify autoregulation characteristics in different CHD types. Results We have obtained data on ten patients thus far, with a goal of twenty CHD patients by March. The correlation coefficient thus far is statistically significant (p < 0.05).
