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A way to measure brain blood flow in pre-term babies at the bedside: The ultrasound technique is noninvasive and captures flow in 3D

Researchers have discovered a novel, non-invasive way to measure blood flow to the brains of newborn children at the bedside — a method that has the potential to enhance diagnosis and treatment across medicine, a Michigan Medicine study suggests.

When a fetus develops, the baby’s lungs are filled with fluid, and oxygen comes directly from the placenta. This oxygenated blood bypasses the lungs to reach the rest of the body through a vessel called the ductus arteriosus.

After birth, babies use their lungs to breathe, and the ductus arteriosus typically closes within several days. But for nearly 65% of pre-term infants, the vessel fails to close. This condition, called patent ductus arteriosus, or PDA, shifts blood flow into an abnormal path which can strain the heart, congest the lungs and steal blood and oxygen from the newborn baby’s brain and other organs.

Physicians must decide whether to attempt to close the PDA with medications or an implanted device, both of which have risks. Accurately measuring blood flow to the newborn’s organs could help with this important decision. But an issue arises: there is no true blood flow measurement that practically works for clinical use, said Jonathan Rubin, M.D., Ph.D., professor emeritus of radiology at University of Michigan Medical School.

“This decision about whether to close the patent ductus arteriosus has been an issue in neonatology for at least 30 years,” Rubin said. “The debate really hangs on how the blood flow has shifted, complicated by a history of unreliable data, which is why a measurement of blood flow is so important.”

To address this problem, Rubin and a team of researchers at Michigan Medicine developed a real-time ultrasound color flow technique that relies on 3D sampling to measure blood flow. They tested the method on 10 healthy, full-term babies, obtaining total brain blood flow measurements that closely match those using more invasive or technically demanding techniques. The results are published in Ultrasound in Medicine and Biology.

“With our method, we are able to scan babies in the parent’s arms with no pain or danger — nobody has really been able to do that before,” said Rubin, a lead author of the paper.

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