Cerebral hemodynamics and oxygenation in 18 perinatally asphyxiated neonates were compared with 13 healthy controls using near-infrared spectroscopy (NIRS) at the Dept of Pediatrics, University Hospital of Leiden, The Netherlands. Cerebral blood volume (CBV) in the first 12 hours of life was decreased in all of 9 severely asphyxiated neonates who subsequently developed neurologic abnormalities. This decrease in CBV was associated with a drop in HbO2 and cytochrome oxidase. All patients showed stable CBV and enzyme patterns at 12 to 24 hours,. The findings suggest that posthypoxic-ischemic reperfusion injury of the brain occurs during early neonatal life after severe birth asphyxia. [1]

COMMENT. The decrease in cerebral CBV, oxyhemoglobin, and cytochrome oxidase during the first 12 hours of life are indicators of decreased cerebral perfusion and oxygenation. The authors propose a possible relation between a decreased CBV and adverse neurologic outcome, suggesting a relation between cerebral hypoperfusion and brain tissue damage in severely asphyxiated neonates. NIRS may be used to monitor changes in CBV of neonates.