Understanding near-infrared spectroscopy.

Near-infrared spectroscopy (NIRS) is a noninvasive technique that monitors regional tissue oxygenation reflecting perfusion status. Near-infrared spectroscopy has the ability to continuously and simultaneously monitor tissue perfusion in different organ systems at the bedside without interrupting routine care. Research has demonstrated its benefit in monitoring cerebral, intestinal, and renal perfusion to detect potential ischemic episodes. Near-infrared spectroscopy can augment current physiologic monitoring to increase awareness of abnormal perfusion status in the preterm population and potentially reduce risks associated with many diseases that may lead to ischemic injury. This article provides an overview describing NIRS technology and function, its current use in neonatology, and pertinent research findings illustrating its benefit in the neonatal population. Near-infrared spectroscopy may evolve into an important diagnostic and prognostic tool for neonatal treatment and outcome.

[1]  D. Andropoulos,et al.  Mesenteric oxyhemoglobin desaturation improves with patent ductus arteriosus ligation , 2006, Journal of Perinatology.

[2]  Anna Petrova,et al.  Near-infrared spectroscopy in the detection of regional tissue oxygenation during hypoxic events in preterm infants undergoing critical care , 2006, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[3]  J. Saul,et al.  Fluctuating Pressure-Passivity Is Common in the Cerebral Circulation of Sick Premature Infants , 2007, Pediatric Research.

[4]  J. Carver,et al.  Factors that influence mesenteric artery blood flow velocity in newborn preterm infants , 2006, Journal of Perinatology.

[5]  L. Brion,et al.  Splanchnic tissue oxygenation, but not brain tissue oxygenation, increases after feeds in stable preterm neonates tolerating full bolus orogastric feeding , 2009, Journal of Perinatology.

[6]  R. Gates,et al.  Technique for the Norwood Procedure Using Normothermic Selective Cerebral Perfusion , 2007, ASAIO journal.

[7]  S. Van Huffel,et al.  New measurements for assessment of impaired cerebral autoregulation using near-infrared spectroscopy. , 2009, Advances in experimental medicine and biology.

[8]  R. Friesen,et al.  Correlation of abdominal site near-infrared spectroscopy with gastric tonometry in infants following surgery for congenital heart disease* , 2008, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[9]  K. Pichová,et al.  Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant , 2009, Acta paediatrica.

[10]  T. Grossmann.  Shedding light on infant brain function: the use of near‐infrared spectroscopy (NIRS) in the study of face perception , 2008, Acta paediatrica.

[11]  K. Fenton,et al.  Cerebral oxygen saturation does not normalize until after stage 2 single ventricle palliation. , 2007, The Annals of thoracic surgery.

[12]  J. Tobias.  Cerebral Oximetry Monitoring with Near Infrared Spectroscopy Detects Alterations in Oxygenation Before Pulse Oximetry , 2008, Journal of intensive care medicine.

[13]  A. J. Petros,et al.  Near infrared spectroscopy can detect changes in splanchnic oxygen delivery in neonates during apnoeic episodes , 1999, European Journal of Pediatrics.

[14]  Frank van Bel,et al.  Cerebral oxygenation and cerebral oxygen extraction in the preterm infant: the impact of respiratory distress syndrome , 2006, Experimental Brain Research.

[15]  C. Giannakopoulou,et al.  Significance of hypocarbia in the development of periventricular leukomalacia in preterm infants , 2004, Pediatrics international : official journal of the Japan Pediatric Society.

[16]  F. Jöbsis.  Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. , 1977, Science.

[17]  C. Roll,et al.  Cerebral blood volume changes during closure by surgery of patent ductus arteriosus , 2007, Archives of Disease in Childhood Fetal and Neonatal Edition.

[18]  M. Toet,et al.  Impact of Patent Ductus Arteriosus and Subsequent Therapy With Indomethacin on Cerebral Oxygenation in Preterm Infants , 2008, Pediatrics.

[19]  D. Andropoulos,et al.  Mesenteric oxygen desaturation in an infant with congenital heart disease and necrotizing enterocolitis. , 2007, Texas Heart Institute journal.

[20]  S. Van Huffel,et al.  Surgical closure of the patent ductus arteriosus and its effect on the cerebral tissue oxygenation , 2008, Acta paediatrica.

[21]  P. Fortune,et al.  Cerebro-splanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischaemia in neonates , 2001, Intensive Care Medicine.

[22]  H. Ford,et al.  Current concepts regarding the pathogenesis of necrotizing enterocolitis , 2009, Pediatric Surgery International.

[23]  Markus Weiss,et al.  Measurement of cerebral oxygenation state in anaesthetized children using the INVOS 5100 cerebral oximeter , 2003, Paediatric anaesthesia.

[24]  M. Sherman,et al.  Near-Infrared Spectroscopy as a Screening Tool for Patent Ductus Arteriosus in Extremely Low Birth Weight Infants , 2006, Neonatology.

[25]  J. Tweddell,et al.  Near infrared spectroscopy monitoring during pediatric aortic coarctation repair , 2006, Paediatric anaesthesia.

[26]  Markus Weiss,et al.  Near‐infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation , 2005, Paediatric anaesthesia.

[27]  B. Sood,et al.  Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm neonates , 2011, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[28]  C. Fraser,et al.  A noninvasive estimation of mixed venous oxygen saturation using near‐infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients , 2005, Paediatric anaesthesia.

[29]  Fizan Abdullah.  Necrotizing Enterocolitis: Finding Infants at Highest Risk , 2008, Journal of Perinatology.

[30]  S. Van Huffel,et al.  Quantitation of the concordance between cerebral intravascular oxygenation and mean arterial blood pressure for the detection of impaired autoregulation. , 2003, Advances in experimental medicine and biology.

[31]  J. Tweddell,et al.  Changes in cerebral and somatic oxygenation during stage 1 palliation of hypoplastic left heart syndrome using continuous regional cerebral perfusion. , 2004, The Journal of thoracic and cardiovascular surgery.

[32]  M. Wilkinson,et al.  Impaired Autoregulation in Preterm Infants Identified by Using Spatially Resolved Spectroscopy , 2008, Pediatrics.

[33]  C. Nankervis,et al.  Newborn intestinal circulation. Physiology and pathophysiology. , 2002, Clinics in perinatology.

[34]  S. Van Huffel,et al.  The effect of changes in tPCO2 on the fractional tissue oxygen extraction--as measured by near-infrared spectroscopy--in neonates during the first days of life. , 2009, European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society.

[35]  T. Yanowitz,et al.  Blood transfusion alters the superior mesenteric artery blood flow velocity response to feeding in premature infants. , 2009, American journal of perinatology.

[36]  R. Holman,et al.  Necrotising enterocolitis hospitalisations among neonates in the United States. , 2006, Paediatric and perinatal epidemiology.

[37]  A. Marson,et al.  Effect of carbon dioxide on background cerebral electrical activity and fractional oxygen extraction in very low birth weight infants just after birth , 2005, Pediatric Research.

[38]  P. Kirshbom,et al.  Cerebral Near Infrared Spectroscopy Is a Reliable Marker of Systemic Perfusion in Awake Single Ventricle Children , 2007, Pediatric Cardiology.

[39]  M. Ferrari,et al.  Surgical closure of patent ductus arteriosus reduces the cerebral tissue oxygenation index in preterm infants: a near‐infrared spectroscopy and Doppler study , 2006, Pediatrics international : official journal of the Japan Pediatric Society.

[40]  S. Nicolson,et al.  Arterial and Venous Contributions to Near-infrared Cerebral Oximetry , 2000, Anesthesiology.

[41]  Steven M Schwartz,et al.  Brain magnetic resonance imaging abnormalities after the Norwood procedure using regional cerebral perfusion. , 2005, The Journal of thoracic and cardiovascular surgery.

[42]  Sabine Van Huffel,et al.  Use of Tissue Oxygenation Index and Fractional Tissue Oxygen Extraction as Non-Invasive Parameters for Cerebral Oxygenation , 2007, Neonatology.

[43]  P. Theocharis,et al.  Incidence and risk factors for cerebral palsy in infants with perinatal problems: a 15-year review. , 2007, Early human development.

[44]  P. Rehak,et al.  Monitoring of selective antegrade cerebral perfusion using near infrared spectroscopy in neonatal aortic arch surgery , 2005, European journal of anaesthesiology.

[45]  Namasivayam Ambalavanan,et al.  Both Extremes of Arterial Carbon Dioxide Pressure and the Magnitude of Fluctuations in Arterial Carbon Dioxide Pressure Are Associated With Severe Intraventricular Hemorrhage in Preterm Infants , 2007, Pediatrics.