by Sølvi Normannsen, Norwegian University of Science and Technology

For children who come out of the mother’s womb before week 28 of pregnancy, the chance of brain damage is as high as 50%. At St. Olav’s Hospital in Trondheim alone, about 300 children are put under anesthesia each year before they turn 1. Credit: Sigrid Dannheim Vik

Ultrasound technology developed at the Norwegian University of Science and Technology (NTNU) makes it possible to monitor cerebral blood flow in newborn babies, helping prevent brain damage in premature and sick infants who require surgery.

Researchers and neonatal specialists at NTNU and St. Olavs Hospital are behind the first study in which ultrasound is used to monitor cerebral blood flow in newborn babies under general anesthesia.

"We have always believed that this could revolutionize neonatal care. Everything indicates that we are closer to being able to prevent brain damage in premature infants and sick newborns," says pediatrician Sigrid Dannheim Vik, who is doing a Ph.D. on NeoDoppler technology.

Over a two-year period, she has used the equipment to measure cerebral blood flow in 30 newborn babies under general anesthesia. Some of them were born very prematurely. Others came into the world around their due date but were born with congenital defects that had developed in the womb.

Most of the patients had gastrointestinal complications, such as lack of passage through the small intestine. Premature babies often have an immature intestine that is easily perforated in the neonatal period.

"These babies require surgery—often acutely. There is no other choice," says Vik.

The longest courses of continuous ultrasound measurements lasted 10–11 hours, and some of her patients weighed less than 1,000 grams.

Regardless of whether they were born very prematurely or have congenital defects and injuries, these are the health service's smallest and most vulnerable patients.

Babies who are born prematurely are prone to brain damage in the neonatal period and are very vulnerable to blood pressure fluctuations. The risk increases if they have to undergo surgery.

The aim of the NTNU study, now published in BJA Open, has been to use the new ultrasound technology to see how cerebral blood flow changes while the infants are under general anesthesia.

The conclusion is that NeoDoppler provides doctors with access to critical information that has previously been unavailable.

"The equipment provides important additional information compared with today's standard monitoring equipment," Vik said.

Currently, indirect factors such as blood pressure, pulse measurements and general clinical assessments are used to see if the child has adequate blood circulation.

"We don't actually have a reliable measurement method for monitoring the most important organ, namely the brain," says the pediatrician and researcher.

More information: Sigrid D. Vik et al, Continuous monitoring of cerebral blood flow during general anaesthesia in infants, BJA Open (2023). DOI: 10.1016/j.bjao.2023.100144

Provided by Norwegian University of Science and Technology