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Noninvasive optical monitoring of cerebral hemodynamics immediately after birth in neonates with congenital heart disease
Journal article   Open access   Peer reviewed

Noninvasive optical monitoring of cerebral hemodynamics immediately after birth in neonates with congenital heart disease

Chloe N. Winston, Madison E. Bowe, Sura Lee, Nicolina R. Ranieri, Anne Ades, Juliana Gebb, Jack Rychik, Maryam Y. Naim, Anna Bostwick, Rodrigo M. Forti, …
Resuscitation plus, v 28, 101272
01 Mar 2026
DOI: https://doi.org/10.1016/j.resplu.2026.101272
PMID: 41994208
url
https://doi.org/10.1016/j.resplu.2026.101272View
Published, Version of Record (VoR) Open CC BY-NC-ND V4.0

Abstract

Cerebral blood flow Cerebral monitoring Cerebral saturation Near-infrared spectroscopy Neonatal resuscitation Congenital Heart Disease
Objective Critical congenital heart disease is associated with altered cerebral hemodynamics in the neonatal period, but the effect on cerebral physiology earlier in life during the fetal to neonatal transition period is yet to be elucidated. This period of neonatal resuscitation could represent an opportunity for intervention, so we aimed to characterize cerebral hemodynamics immediately after birth in four neonates with critical congenital heart disease using noninvasive optical monitoring. Methods This case series analysis included term neonates with hypoplastic left heart syndrome or with transposition of the great arteries who were born at Children’s Hospital of Philadelphia. Continuous measurements of cerebral blood flow, cerebral tissue oxygen saturation, and cerebral metabolic rate of oxygen were acquired non-invasively during the first hour after birth with near-infrared spectroscopy, frequency-domain diffuse optical spectroscopy, and diffuse correlation spectroscopy techniques. Results In all four newborns, cerebral tissue oxygen saturation was lower than reference values in the literature. Additionally, we observed decreases in cerebral blood flow and oxygen metabolism during postnatal transition that were not reflected by standard of care metrics such as peripheral oxygen saturation. The decreases were spontaneous in infants with hypoplastic left heart syndrome and temporally associated with invasive respiratory support in infants with transposition of the great arteries. Conclusion This case series demonstrates periods of possible neurological vulnerability during postnatal transition in critical congenital heart disease and motivates further study of cerebral physiology during the transition period using advanced optical techniques.

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