A Michigan Medicine study shows that scientists have developed a unique, non-invasive technique for measuring blood flow to newborn children’s brains at the bedside. This technique may improve medical diagnosis and treatment in general.
A fetus’s lungs are filled with fluid as they grow, and the placenta is the baby’s only source of oxygen. Through a blood channel known as the ductus arteriosus, this oxygenated blood bypasses the lungs and travels to the rest of the body.
Babies breathe through their lungs after birth, and the ductus arteriosus usually closes in a few days. However, the vessel doesn’t close for around 65% of pre-term newborns. Patent ductus arteriosus, or PDA, is a condition in which blood flows in the wrong direction. This puts stress on the heart and lungs and keeps the brain and other organs of the baby from getting enough oxygen and blood.
Considering the hazards of both implanted devices and drugs, doctors must choose whether to try and close the PDA. A precise measurement of blood flow to the newborn’s organs could aid in making this crucial choice. However, there is a problem: according to Jonathan Rubin, M.D., Ph.D., professor emeritus of radiology at the University of Michigan Medical School, there is no real blood flow measurement that can be used in a clinical setting.
According to Rubin, neonatal medicine has debated whether to close the patent ductus arteriosus for at least 30 years. “Measuring blood flow is very important because the discussion really depends on how blood flow has changed, which is made worse by the fact that wrong data have been given in the past.”
Rubin and a group of researchers at Michigan Medicine created a real-time ultrasound color flow technology that uses 3D sampling to quantify blood flow in order to solve this issue. Using 10 healthy, full-term newborns as test subjects, they were able to acquire total cerebral blood flow measurements that closely matched those obtained using more invasive or technically challenging methods. The findings were published in Ultrasound in Medicine and Biology.
Nobody has truly been able to scan infants in their parents’ arms without pain or danger previously, according to Rubin, a lead author of the study.
“There are a few additional ways to measure blood flow, but they are time-consuming, frequently require intravenous contrast agents, and involve securing or anesthetizing newborns in a scanner. However, premature infants are housed in incubators; they are delicate, and these procedures might be harmful. The frequent use of this ultrasonography technology in neonatal intensive care units may have a major influence on the outcomes of preterm infants with this problem.
How it works
In place of actual blood flow, numerous substitute techniques are utilized, including blood flow velocity. But to understand real blood flow, you need to know how fast the blood moves and how much area it covers.
According to Rubin, if you don’t know how many automobiles are on the road, knowing merely how quickly they are driving won’t assist.
The method created by Rubin and his associates calculates blood flow flux over a surface spanning ultrasonic beams to determine real blood flow. The color image is 3D-scanned.
According to Rubin, since there are no contrast chemicals needed for this procedure, measurements can be taken in real time and repeated as often as necessary.
Game-changing applications
Researchers believe the method could be used to address blood supply to organs such as the brain, liver, and kidneys in a variety of medical conditions such as congestive heart failure, sepsis, and shock because it provides a non-invasive, accurate measure of blood flow.
Gary Weiner, M.D., clinical associate professor of pediatrics at U-M Medical School and medical director of the Brandon Neonatal Intensive Care Unit at U-M Health C.S. Mott Children’s Hospital, said, “In the Neonatal Intensive Care Unit, we must make assumptions every day based on indirect measures to determine how our treatments affect blood flow to the organs of critically ill newborns.”
“A bedside device that lets us measure real blood flow in a safe, quick, and accurate way could change everything.”
However, it doesn’t end with kids. The technique, according to Rubin, has the potential to be utilized virtually anywhere an ultrasound can provide an image, for everything from determining the need for organ transplants to spotting problems during surgical procedures.
According to him, “Clinicians use a variety of techniques to alter blood flow measurements, and the evaluations are always semi-quantitative or rely on erroneous assumptions about the nature of the flow.” “They may utilize Doppler ultrasonography to determine velocity before determining whether there is flow by just feeling a vessel. Because flow occurs everywhere, there is a ton of potential for this application in diagnostic medicine. The technique has already been used to assess flows in adult livers and umbilical cords of fetuses before birth. Several businesses are considering including the technique on common clinical ultrasound scanners.
