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  • Clinical Research Article
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Wearable fiber-free optical sensor for continuous monitoring of neonatal cerebral blood flow and oxygenation

Pediatric Research (2024)Cite this article

Abstract

Background

Unstable cerebral hemodynamics places preterm infants at high risk of brain injury. We adapted an innovative, fiber-free, wearable diffuse speckle contrast flow-oximetry (DSCFO) device for continuous monitoring of both cerebral blood flow (CBF) and oxygenation in neonatal piglets and preterm infants.

Methods

DSCFO uses two small laser diodes as focused-point and a tiny CMOS camera as a high-density two-dimensional detector to detect spontaneous spatial fluctuation of diffuse laser speckles for CBF measurement, and light intensity attenuations for cerebral oxygenation measurement. The DSCFO was first validated against the established diffuse correlation spectroscopy (DCS) in neonatal piglets and then utilized for continuous CBF and oxygenation monitoring in preterm infants during intermittent hypoxemia (IH) events.

Results

Significant correlations between the DSCFO and DCS measurements of CBF variations in neonatal piglets were observed. IH events induced fluctuations in CBF, cerebral oxygenation, and peripheral cardiorespiratory vitals in preterm infants. However, no consistent correlation patterns were observed among peripheral and cerebral monitoring parameters.

Conclusions

This pilot study demonstrated the feasibility of DSCFO technology to serve as a low-cost wearable sensor for continuous monitoring of multiple cerebral hemodynamic parameters. The results suggested the importance of multi-parameter measurements for understanding deep insights of peripheral and cerebral regulations.

Impact

  • The innovative DSCFO technology may serve as a low-cost wearable sensor for continuous bedside monitoring of multiple cerebral hemodynamic parameters in neonatal intensive care units.

  • Concurrent DSCFO and DCS measurements of CBF variations in neonatal piglet models generated consistent results.

  • No consistent correlation patterns were observed among peripheral and cerebral monitoring parameters in preterm neonates, suggesting the importance of multi-parameter measurements for understanding deep insights of peripheral and cerebral regulations during IH events.

  • Integrating and correlating multiple cerebral functional parameters with clinical outcomes may identify biomarkers for prediction and management of IH associated brain injury.

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Fig. 1: rCBF measurement results from Piglet #1 during transient global ischemia and asphyxia.
Fig. 2: rCBF measurements results from Piglet #2 during hypercapnia and transient global cerebral ischemia.
Fig. 3: rCBF, Δ[HbO2], and Δ[Hb] measurement results from Piglet #3 and Piglet #4 during hypercapnia (8%CO2).
Fig. 4: Representative results from Infant #1 and Infant #3 (1st measurement).

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We acknowledge Kimberly Quire and Sara Butler, Department of Pediatrics, University of Kentucky for supporting measurements in NICUs at the Kentucky Children’s Hospital. We also acknowledge Hollie Y. van Rooyen and Jason B. Oakes from the Division of Laboratory Animal Resources at the University of Kentucky for supporting measurements in neonatal piglets.

Funding

Supported partially by the National Institute of Health (NIH, R01-EB028792 to G.Y.; R01-HD101508 to G.Y.; #R56-NS117587 to G.Y.; R21-HD091118 to G.Y.; K23HD109471 to E.G.A.; and UL1-TR001998 to E.G.A.) and University of Kentucky Halcomb Fellowship in Medicine and Engineering to X.L.

Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA

    Xuhui Liu, Mehrana Mohtasebi, Pegah Safavi, Faraneh Fathi, Samaneh Rabienia Haratbar & Guoqiang Yu

  2. Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, University of Kentucky, Lexington, KY, USA

    Li Chen

  3. Department of Internal Medicine and Department of Computer Science, Institute for Biomedical Informatics, University of Kentucky, Lexington, KY, USA

    Jin Chen

  4. Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, KY, USA

    Henrietta S. Bada & Elie G. Abu Jawdeh

  5. Department of Physiology and the Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY, USA

    Lei Chen

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Contributions

G.Y., Lei.C., E.G.A., H.S.B. and X.L. conceived the study. X.L. designed and built the wearable sensor. X.L., M.M., F.F., S.R.H., P.S. acquired data. Lei.C. conducted and supervised animal experiments. E.G.A. conducted and supervised human experiments. X.L., Li.C. and J.C. analyzed and interpreted data. Li.C. performed statistical analysis. Lei.C. provided resources for animal experiments. E.G.A. and H.S.B. provided resources for human experiments. X.L. drafted the manuscript. M.M., F.F., S.R.H., P.S., G.Y., Lei.C., E.G.A., H.S.B., Li.C., J.C. and X.L. reviewed and edited the manuscript. All authors gave final approval of the version to be published.

Corresponding author

Correspondence to Guoqiang Yu.

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The authors declare no competing interests.

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Under a protocol approved by the Institutional Review Board of the University of Kentucky, informed consent was obtained by a physician researcher from each subject’s parents.

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Consent Statement Under a protocol approved by the Institutional Review Board of the University of Kentucky, informed consent was obtained by a physician researcher from each subject’s parents.

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Liu, X., Mohtasebi, M., Safavi, P. et al. Wearable fiber-free optical sensor for continuous monitoring of neonatal cerebral blood flow and oxygenation. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03137-z

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