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Award","award":["R01-NS060653"],"award-info":[{"award-number":["R01-NS060653"]}]},{"name":"Thoracic Surgery Foundation 2021 Nina Starr Braunwald Research Fellowship Award","award":["R01-NS113945"],"award-info":[{"award-number":["R01-NS113945"]}]},{"name":"Thoracic Surgery Foundation 2021 Nina Starr Braunwald Research Fellowship Award","award":["T32-HL007915"],"award-info":[{"award-number":["T32-HL007915"]}]},{"name":"Thoracic Surgery Foundation 2021 Nina Starr Braunwald Research Fellowship Award","award":["R01-HL141386"],"award-info":[{"award-number":["R01-HL141386"]}]},{"name":"Thoracic Surgery Foundation 2021 Nina Starr Braunwald Research Fellowship Award","award":["P41-EB015893"],"award-info":[{"award-number":["P41-EB015893"]}]},{"name":"Thoracic Surgery Foundation 2021 Nina Starr Braunwald Research Fellowship Award","award":["F31-HD085731"],"award-info":[{"award-number":["F31-HD085731"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Cardiopulmonary bypass (CPB) provides cerebral oxygenation and blood flow (CBF) during neonatal congenital heart surgery, but the impacts of CPB on brain oxygen supply and metabolic demands are generally unknown. To elucidate this physiology, we used diffuse correlation spectroscopy and frequency-domain diffuse optical spectroscopy to continuously measure CBF, oxygen extraction fraction (OEF), and oxygen metabolism (CMRO2) in 27 neonatal swine before, during, and up to 24 h after CPB. Concurrently, we sampled cerebral microdialysis biomarkers of metabolic distress (lactate\u2013pyruvate ratio) and injury (glycerol). We applied a novel theoretical approach to correct for hematocrit variation during optical quantification of CBF in vivo. Without correction, a mean (95% CI) +53% (42, 63) increase in hematocrit resulted in a physiologically improbable +58% (27, 90) increase in CMRO2 relative to baseline at CPB initiation; following correction, CMRO2 did not differ from baseline at this timepoint. After CPB initiation, OEF increased but CBF and CMRO2 decreased with CPB time; these temporal trends persisted for 0\u20138 h following CPB and coincided with a 48% (7, 90) elevation of glycerol. The temporal trends and glycerol elevation resolved by 8\u201324 h. The hematocrit correction improved quantification of cerebral physiologic trends that precede and coincide with neurological injury following CPB.<\/jats:p>","DOI":"10.3390\/metabo13111153","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T07:11:27Z","timestamp":1700118687000},"page":"1153","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Diffuse Optical Monitoring of Cerebral Hemodynamics and Oxygen Metabolism during and after Cardiopulmonary Bypass: Hematocrit Correction and Neurological Vulnerability"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7633-489X","authenticated-orcid":false,"given":"Emilie J.","family":"Benson","sequence":"first","affiliation":[{"name":"Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, PA 19104, USA"},{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle I.","family":"Aronowitz","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8978-2525","authenticated-orcid":false,"given":"Rodrigo M.","family":"Forti","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3669-0114","authenticated-orcid":false,"given":"Alec","family":"Lafontant","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6823-8328","authenticated-orcid":false,"given":"Nicolina R.","family":"Ranieri","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Starr","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W.","family":"Melchior","sequence":"additional","affiliation":[{"name":"Department of Perfusion Services, Cardiac Center, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5968-4169","authenticated-orcid":false,"given":"Alistair","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Chemistry, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jharna","family":"Jahnavi","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake","family":"Breimann","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohyun","family":"Yun","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard H.","family":"Laurent","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Anesthesiology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"White","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-5604","authenticated-orcid":false,"given":"J. 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