Reduced cerebral oxygen extraction and metabolic rate in newborns with hypoxic ischemic encephalopathy

Motivation: Over 40% of neonates with moderate or severe hypoxic-ischemic-encephalopathy (HIE) still suffer from death, disability or neurodevelopmental delay after standard hypothermia treatment. Assessment of the brain’s oxygen metabolism may provide useful biomarkers to identify the risk of permanent neurologic injury and determine the necessity of adjuvant treatments. Goal(s): To evaluate cerebral oxygen-extraction-fraction (OEF) and cerebral-metabolic-rate-of-oxygen (CMRO2) in neonates with HIE in comparison with healthy newborns. Approach: We measured OEF and CMRO2 in 42 neonates with HIE and 52 healthy newborns. Results: Neonates with HIE exhibited diminished OEF and CMRO2. Furthermore, a lower OEF predicted a longer stay in the neonatal ICU. Impact: The brain’s physiological parameters such as oxygen-extraction-fraction can provide additional information (beyond standard clinical indices) for cerebral injury evaluation and treatment planning for hypoxic-ischemic-encephalopathy.