Abstract

Critical glycemic events, such as hypo- or hyperglycemia, are extremely common during the first week post-partum in very preterm neonates. Both hypo- and hyperglycemic changes have been associated with poor neurological outcome. Continuous glucose monitoring (CGM) is a promising tool to reduce glycemic variability in the preterm population and whole-head Diffuse Optical Tomography (DOT) is a promising tool for continuous monitoring of brain hemodynamics in newborns. In this study, we performed a combined CGM-DOT acquisition in a very preterm newborn (28 weeks gestational age). The newborn was monitored for 7 days continuously. Twelve events were detected during this period: 8 mild hypoglycemic events, one severe hypoglycemic event, two mild hyperglycemic events and one event with a mild hypo- followed by a mild-hyperglycemia. DOT data were available for all the events but two. DOT data were reconstructed with a neonatal head model for the severe hypoglycemic event before the start of the hypoglycemic event and during the maximum peak of hypoglycemia. These preliminary results showed a regional specificity of the hemodynamic changes during hypoglycemia, with a predominant recruitment of the motor and parietal areas. This study highlights the importance of using whole-head DOT in this research field and the feasibility to perform combined CGM-DOT monitoring in very preterm neonates. Future clinical trials are required to investigate this clinical problem more thoroughly and shed light on the impact of tight glycemic control on the newborn brain.

© 2019 SPIE/OSA