Cerebrovascular reactivity to carbon dioxide tension in newborns: data from combined time-resolved near-infrared spectroscopy and diffuse correlation spectroscopy.

Significance: Critically ill newborns are at risk of brain damage from cerebrovascular disturbances. A cerebral hemodynamic monitoring system would have the potential role to guide targeted intervention.

Aim: To obtain, in a population of newborn infants, simultaneous near-infrared spectroscopy (NIRS)-based estimates of cerebral tissue oxygen saturation () and blood flow during variations of carbon dioxide tension () levels within physiologic values up to moderate permissive hypercapnia, and to examine if the derived estimate of metabolic rate of oxygen would stay constant, during the same variations.

Approach: We enrolled clinically stable mechanically ventilated newborns at postnatal age without brain abnormalities at ultrasound. and blood flow index were measured using a non-invasive device (BabyLux), which combine time-resolved NIRS and diffuse-correlation spectroscopy. The effect of changes in transcutaneous on , cerebral blood flow (CBF), and cerebral metabolic rate of oxygen index () were estimated.

Results: Ten babies were enrolled and three were excluded. Median GA at enrollment was 39 weeks and median weight 2720 g. increased 0.58% (95% CI 0.55; 0.61, ), CBF 2% (1.9; 2.3, ), and 0.3% (0.05; 0.46, ) per mmHg increase in .

Conclusions: BabyLux device detected -induced changes in cerebral and CBF, as expected. The small statistically significant positive relationship between and variation is not considered clinically relevant and we are inclined to consider it as an artifact.