scholarly journals Has the time come to use near-infrared spectroscopy as a routine clinical tool in preterm infants undergoing intensive care?

2011 ◽  
Vol 369 (1955) ◽  
pp. 4440-4451 ◽  
Author(s):  
Gorm Greisen ◽  
Terence Leung ◽  
Martin Wolf
Keyword(s):  
Intensive Care ◽  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Clinical Care ◽  
First Grade ◽  
Diagnostic Methods ◽  
Cerebral Oximetry ◽  
Extremely Preterm

Several instruments implementing spatially resolved near-infrared spectroscopy (NIRS) to monitor tissue oxygenation are now approved for clinical use. The neonatal brain is readily assessible by NIRS and neurodevelopmental impairment is common in children who were in need of intensive care during the neonatal period. It is likely that an important part of the burden of this handicap is due to brain injury induced by hypoxia–ischaemia during intensive care. In particular, this is true for infants born extremely preterm. Thus, monitoring of cerebral oxygenation has considerable potential benefit in this group. The benefit, however, should be weighed against the disturbance to the infant, against the limitations imposed on clinical care and against costs. The ultimate way of demonstrating the ‘added value’ is by a randomized controlled trial. Cerebral oximetry must reduce the risk of a clinically relevant endpoint, such as death or neurodevelopmental handicap. We estimate that such a trial should recruit about 4000 infants to have the power to detect a reduction in brain injury by one-fifth. This illustrates the formidable task of providing first-grade evidence for the clinical value of diagnostic methods. Is it a window of opportunity for the establishment of a rational basis before another technology is added to an already overly complex newborn intensive care?

scholarly journals Brain monitoring using near-infrared spectroscopy to predict outcome after cardiac arrest: a novel phenotype in a rat model of cardiac arrest

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ryosuke Takegawa ◽  
Kei Hayashida ◽  
Rishabh Choudhary ◽  
Daniel M. Rolston ◽  
Lance B. Becker
Keyword(s):  
Cardiac Arrest ◽  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oximetry ◽  
Neurological Outcomes ◽  
Non Invasive ◽  
Real Time Measurement ◽  
Ca Model

AbstractImproving neurological outcomes after cardiac arrest (CA) is the most important patient-oriented outcome for CA research. Near-infrared spectroscopy (NIRS) enables a non-invasive, real-time measurement of regional cerebral oxygen saturation. Here, we demonstrate a novel, non-invasive measurement using NIRS, termed modified cerebral oximetry index (mCOx), to distinguish the severity of brain injury after CA. We aimed to test the feasibility of this method to predict neurological outcome after asphyxial CA in rats. Our results suggest that mCOx is feasible shortly after resuscitation and can provide a surrogate measure for the severity of brain injury in a rat asphyxia CA model.

Near-Infrared Spectroscopy Monitoring of Cerebral Oxygenation and Influencing Factors in Neonates from High-Altitude Areas

Neonatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Bi Ze ◽  
Lili Liu ◽  
Ge Sang Yang Jin ◽  
Minna Shan ◽  
Yuehang Geng ◽  
...  
Keyword(s):  
Heart Disease ◽  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Low Altitude ◽  
Normal Neonates

<b><i>Background:</i></b> Accurate detection of cerebral oxygen saturation (rSO<sub>2</sub>) may be useful for neonatal brain injury prevention, and the normal range of rSO<sub>2</sub> of neonates at high altitude remained unclear. <b><i>Objective:</i></b> To compare cerebral rSO<sub>2</sub> and cerebral fractional tissue oxygen extraction (cFTOE) at high-altitude and low-altitude areas in healthy neonates and neonates with underlying diseases. <b><i>Methods:</i></b> 515 neonates from low-altitude areas and 151 from Tibet were enrolled. These neonates were assigned into the normal group, hypoxic-ischemic encephalopathy (HIE) group, and other diseases group. Near-infrared spectroscopy was used to measure rSO<sub>2</sub> in neonates within 24 h after admission. The differences of rSO<sub>2</sub>, pulse oxygen saturation (SpO<sub>2</sub>), and cFTOE levels were compared between neonates from low- and high-altitude areas. <b><i>Results:</i></b> (1) The mean rSO<sub>2</sub> and cFTOE levels in normal neonates from Tibet were 55.0 ± 6.4% and 32.6 ± 8.5%, significantly lower than those from low-altitude areas (<i>p</i> &#x3c; 0.05). (2) At high altitude, neonates with HIE, pneumonia (<i>p</i> &#x3c; 0.05), anemia, and congenital heart disease (<i>p</i> &#x3c; 0.05) have higher cFTOE than healthy neonates. (3) Compared with HIE neonates from plain areas, neonates with HIE at higher altitude had lower cFTOE (<i>p</i> &#x3c; 0.05), while neonates with heart disease in plateau areas had higher cFTOE than those in plain areas (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The rSO<sub>2</sub> and cFTOE levels in normal neonates from high-altitude areas are lower than neonates from the low-altitude areas. Lower cFTOE is possibly because of an increase in blood flow to the brain, and this may be adversely affected by disease states which may increase the risk of brain injury.

scholarly journals Near-Infrared Spectroscopy in Extremely Preterm Infants

2021 ◽  
Vol 8 ◽  
Author(s):  
Leeann R. Pavlek ◽  
Clifford Mueller ◽  
Maria R. Jebbia ◽  
Matthew J. Kielt ◽  
Omid Fathi
Keyword(s):  
Infrared Spectroscopy ◽  
Preterm Infants ◽  
Near Infrared Spectroscopy ◽  
Neonatal Intensive Care ◽  
Near Infrared ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Potential Applications

With advances in neonatal care, survival of premature infants at the limits of viability has improved significantly. Despite these improvement in mortality, infants born at 22–24 weeks gestation are at a very high risk for short- and long-term morbidities associated with prematurity. Many of these diseases have been attributed to abnormalities of tissue oxygenation and perfusion. Near-infrared spectroscopy utilizes the unique absorption properties of oxyhemoglobin and deoxyhemoglobin to provide an assessment of regional tissue oxygen saturation, which can be used to calculate the fractional tissue oxygen extraction. This allows for a non-invasive way to monitor tissue oxygen consumption and enables targeted hemodynamic management. This mini-review provides a brief and complete overview of the background and physiology of near-infrared spectroscopy, practical use in extremely preterm infants, and potential applications in the neonatal intensive care unit. In this mini-review, we aim to summarize the three primary application sites for near-infrared spectroscopy, disease-specific indications, and available literature regarding use in extremely preterm infants.

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