Researchers find method for monitoring preterm infants’ brain blood flow at bedside

Michigan [US], October 11 (ANI): A Michigan Medicine study shows that scientists have developed a unique, non-invasive technique for measuring blood flow to newborn children’s brains at the bedside. This technique may improve medical diagnosis and treatment in general.
A fetus’s lungs are filled with fluid as it grows, and the placenta is the baby’s only source of oxygen. Through a blood channel known as the ductus arteriosus, this oxygenated blood bypasses the lungs and travels to the rest of the body.
Babies breathe through their lungs after birth, and the ductus arteriosus usually closes in a few days. However, the vessel doesn’t close for around 65% of pre-term newborns. The disorder known as patent ductus arteriosus, or PDA, causes blood to flow in an irregular direction, placing stress on the heart and lungs and depriving the baby’s brain and other organs of oxygen and blood.
Considering the hazards of both implanted devices and drugs, doctors must choose whether to try and close the PDA. A precise measurement of blood flow to the newborn’s organs could aid in making this crucial choice. However, there is a problem: according to Jonathan Rubin, M.D., PhD, professor emeritus of radiology at the University of Michigan Medical School, there is no real blood flow measurement that can be used in a clinical setting.
“This decision about whether to close the patent ductus arteriosus has been an issue in neonatology for at least 30 years,” Rubin said. “The debate really hangs on how the blood flow has shifted, complicated by a history of unreliable data, which is why a measurement of blood flow is so important.”
Rubin and a group of researchers at Michigan Medicine created a real-time ultrasound colour flow technology that uses 3D sampling to quantify blood flow in order to solve this issue. Using 10 healthy, full-term newborns as test subjects, they could acquire total cerebral blood flow measurements that closely matched those obtained using more invasive or technically challenging methods. Published in Ultrasound in Medicine and Biology are the findings.
“With our method, we are able to scan babies in the parent’s arms with no pain or danger — nobody has really been able to do that before,” said Rubin, a lead author of the paper.
“There are several other methods of measuring blood flow, but they are cumbersome and often require intravenous contrast agents, with babies being sedated or restrained in a scanner. But pre-term babies are in incubators; they are fragile, and these techniques can be dangerous. This ultrasound technique could be used routinely in neonatal intensive care units, which could significantly impact outcomes for pre-term babies with this condition.”
How it works
In place of actual blood flow, numerous substitute techniques are utilised, including blood flow velocity. However, to understand natural blood flow, one must be aware of the blood’s velocity in relation to the area it covers.
According to Rubin, if you don’t know how many automobiles are on the road, knowing merely how quickly they are driving won’t assist.
The method created by Rubin and his associates calculates blood flow flux over a surface spanning ultrasonic beams to determine real blood flow. The colour image is 3D-scanned.
Since there are no contrast chemicals needed for this procedure, measurements can be taken in real-time and repeated as often as necessary, according to Rubin.
Game-changing applications
Researchers claim the method might be used to address blood supply to organs like the brain, the liver, and the kidneys in numerous illness conditions like congestive heart failure, sepsis, and shock because it provides a non-invasive, correct measure of blood flow.
Gary Weiner, M.D., clinical associate professor of paediatrics at U-M Medical School and medical director of the Brandon Neonatal Intensive Care Unit at U-M Health C.S. Mott Children’s Hospital, said, “In the Neonatal Intensive Care Unit, we must make assumptions every day based on indirect measures to determine how our treatments affect blood flow to the organs of critically ill newborns.
“Having a bedside gadget that allows us to assess actual blood flow in a safe, quick, and precise manner could be a game changer.”
However, it doesn’t end with kids. The technique, according to Rubin, has the potential to be utilised virtually any place an ultrasound can provide an image, for everything from determining the need for organ transplants to spotting problems during surgical procedures.
“Clinicians perform all kinds of manoeuvres to modify blood flow measurements, and the assessments are always semi-quantitative or make unjustified assumptions about the nature of the flow,” he said. “They may use a Doppler ultrasound to get velocity, but then just feel a vessel to feel if there is flow. There is so much potential for this application in diagnostic medicine because the flow is everywhere. We have already used the method to measure flows in umbilical cords in fetuses before birth and in livers in adults. Several companies are evaluating the method for inclusion on standard clinical ultrasound scanners.” (ANI)