Abstract
Background
Development of cerebral edema after brain injury carries a high risk for brain damage and death. The present study tests the ability of a noninvasive cerebral edema monitoring system that uses near-infrared spectroscopy (NIRS) with water as the chromophore of interest to detect brain edema following hypoxia.
Methods
Ventilated piglets were exposed to hypoxia for 1 h, and then returned to normal oxygen levels for 4 h. An NIRS sensor was placed on the animal’s head at baseline, and changes in light attenuation were converted to changes in H2O. Cerebral water content and aquaporin-4 protein (AQP4) expression were measured.
Results
The system detected changes in NIRS–derived water signal as early as 2 h after hypoxia, and provided fivefold signal amplification, representing a 10% increase in brain water content and a sixfold increase in AQP4, 4 h after hypoxia. Changes in water signal correlated well with changes in cerebral water content (R=0.74) and AQP4 expression (R=0.97) in the piglet brain.
Conclusion
The data show that NIRS can detect cerebral edema early in the injury process, thus providing an opportunity to initiate therapy at an earlier and more effective time-point after an insult than is available with current technology.
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Acknowledgements
We thank Baruch Ben Dor, John Grothusen, Juan Du, and Jessica Button for their technical assistance. This project was funded, in part, under a grant with the Pennsylvania Department of Health SAP Number: 4100068711, and by the Coulter-Drexel Translational Research Partnership Program under grant number: 282812-3850.
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This project was funded, in part, under a grant with the Pennsylvania Department of Health SAP Number: 4100068711, and by the Coulter-Drexel Translational Research Partnership Program under grant number: 282812-3850.
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Malaeb, S., Izzetoglu, M., McGowan, J. et al. Noninvasive monitoring of brain edema after hypoxia in newborn piglets. Pediatr Res 83, 484–490 (2018). https://doi.org/10.1038/pr.2017.264
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DOI: https://doi.org/10.1038/pr.2017.264
