Continuous monitoring of cerebral blood flow during general anaesthesia in infants

BackgroundGeneral anaesthesia is associated with neurocognitive deficits in infants after noncardiac surgery. Disturbances cerebral perfusion as a result of systemic hypotension and impaired autoregulation may be potential cause. Our aim was to study blood flow (CBF) velocity continuously during general undergoing surgery compare variations CBF simultaneously measured near-infrared spectroscopy (NIRS), pressure, heart rate.MethodsNeoDoppler, recently developed ultrasound system, used monitor via the anterior fontanelle induction maintenance until start surgery, recovery. NIRS, rate were monitored synchronised NeoDoppler measurements.ResultsThirty infants, median postmenstrual age at 37.6 weeks (range 28.6–60.0) included. Compared baseline, trend curves showed decrease returned baseline values End-diastolic decreased all anaesthesia, on average by 59%, whereas peak systolic- time-averaged velocities 26% 45%, respectively. In comparison, reduction mean arterial pressure only 20%. NIRS high remained stable. When adjusting for significant end-diastolic persisted, there small systolic velocity.ConclusionsContinuous monitoring using feasible provide valuable information about contributing more targeted haemodynamic management anaesthetised infants.