# Investigation of Cerebral Hemodynamics and Oxygenation Relationships Under Sedation in Children: ICHOR USC

> **NIH NIH K25** · CHILDREN'S HOSPITAL OF LOS ANGELES · 2021 · $185,760

## Abstract

Project Summary
The broad objective of this research is to use neuroimaging to understand the hemodynamic responses 
to anesthesia and sedation. Anesthesia and sedation, commonly used in pediatric patients, cause 
profound and rapid changes in cerebral blood flow and metabolism. Under normal conditions in 
adults, these changes are tightly coupled to one another to protect the brain from hypoxia and 
ischemia. However, the extent to which flow and metabolism are coupled during anesthesia and 
sedation in pediatric patients is unknown. The aims of this project are (1) to quantify the 
hemodynamic and metabolic responses to anesthesia in infants, and (2) to compare those responses 
during the administration of specific anesthetics in infants with differing disease states that may 
make them more vulnerable to the uncoupling of flow from metabolism. If our hypotheses are borne 
out and infants are particularly vulnerable to this uncoupling, our findings will lead to future 
studies to assess hemodynamic responses as potential biomarkers that predict and mediate adverse 
outcomes in infants exposed to anesthesia. Therefore, this project is relevant to the NHLBI's 
strategic objective to identify factors that account for individual differences in pathobiology and 
treatment response.
This project requires an opportunity for making simultaneous flow and metabolism measurements in 
anesthetized infants. Clinical MR imaging provides this opportunity. Therefore, we will enroll into 
a Naturalistic Cohort Study 120 infants younger than 1 year of age who require a clinical MRI scan, 
half receiving anesthesia and half not. Enrolled infants will be imaged with MRI sequences that 
measure cerebral blood flow and metabolism. In addition, we will enroll 30 additional infants of 
the same age into a Pilot Randomized Comparator Trial (RCT), in which the infants will be 
randomized to receive either propofol or sevoflurane anesthesia. Randomization will dramatically 
reduce potential confounding of diseases and anesthetic agents present in the naturalistic study.
Learning to design RCTs (Goal 1) is addressed with didactics and a practicum to advance my 
translational research skills. This project requires my learning how anesthetics and sedatives 
alter hemodynamics and fluid dynamics (Goal 2) and how the known and putative mechanisms of 
neurotoxicity and flow-metabolism uncoupling affect the developing brain (Goal 3). This project and 
my research career will help infants who require anesthesia or sedation. It creates a paradigm in 
which the hemodynamic response to anesthesia can be explored safely in pediatric critical care 
patients. It requires the combination of MRI and image processing know-how - skills that I already 
have - with a deeper understanding of the pathophysiological consequences of altered hemodynamic 
responses to anesthesia in infants. It also requires that I develop an improved ability to design 
research projects that fit within a rigorous...

## Key facts

- **NIH application ID:** 10216102
- **Project number:** 1K25HL153954-01A1
- **Recipient organization:** CHILDREN'S HOSPITAL OF LOS ANGELES
- **Principal Investigator:** Matthew Borzage
- **Activity code:** K25 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $185,760
- **Award type:** 1
- **Project period:** 2021-09-10 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10216102

## Citation

> US National Institutes of Health, RePORTER application 10216102, Investigation of Cerebral Hemodynamics and Oxygenation Relationships Under Sedation in Children: ICHOR USC (1K25HL153954-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10216102. Licensed CC0.

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