TY - JOUR
T1 - Cerebral near-infrared spectroscopy guided neonatal intensive care management for the preterm infant
AU - Pellicer, Adelina
AU - de Boode, Willem
AU - Dempsey, Eugene
AU - Greisen, Gorm
AU - Mintzer, Jonathan
AU - Naulaers, Gunnar
AU - Pichler, Gerhard
AU - Roehr, Charles Christoph
AU - Roll, Claudia
AU - Schwarz, Christoph
AU - da Costa, Cristine Sortica
AU - Kooi, Elisabeth
AU - Wong, Flora
AU - Wolf, Martin
AU - Roehr, Charles Christoph
AU - Rhee, Christopher
AU - Hansen, Mathias Luhr
AU - Levy, Philip
AU - Lemmers, Petra
AU - Ergenekon, Ebru
AU - Austin, Topun
AU - Alderliesten, Thomas
AU - Alarcon-Allen, Ana
AU - on behalf of the ESPR Special Interest Group “Near InfraRed Spectroscopy” (NIRS)
N1 - Funding Information:
Financial support of publication costs by the European Society for Paediatric Research (ESPR) is gratefully acknowledged.
Publisher Copyright:
© The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2024.
PY - 2024
Y1 - 2024
N2 - Abstract: Infants requiring admission to the neonatal intensive care unit (NICU) are particularly vulnerable to developing brain injury. The severity of the underlying clinical conditions and the complexity of care call for continuous, cot-side, non-invasive monitoring tools. Near-infrared spectroscopy (NIRS) measures the regional tissue oxygen saturation of hemoglobin (rStO2) and provides continuous information on the net-result of several factors. Cerebral rStO2 correlates with echocardiography-derived measures of blood flow. Cerebral fractional tissue oxygen extraction provides information on the balance between oxygen supply and demand and can be continuously derived from the combined use of cerebral rStO2 and arterial oxygen saturation. Information on cerebral blood flow autoregulatory capacity can be obtained from combining cerebral rStO2 and invasive blood pressure monitoring by appropriate software. Cerebral rStO2 provides real-time, end-organ information on perfusion-oxygenation, and when interpreted in the clinical context based on pathophysiological principles may be used as a help to guide interventions in the NICU. In this review we will discuss how to optimize NIRS monitoring for application in the NICU, with a particular focus on the preterm infant. Impact: Near-infrared spectroscopy (NIRS) provides cot-side, real-time information on blood and oxygen supply to the brain. Therefore, it is a valuable tool to better understand the pathophysiology underlaying disease processes. Current evidence suggests that NIRS-guided treatment in extremely preterm infants during transitional circulation does not improve clinical outcomes. Specific training is needed to maximize potential performance. Pathophysiological interpretation of cerebral NIRS data in the given clinical context may help in decision-making. Appropriate use of this monitoring technique, interpreted concurrently with other routine parameters, is a potential clinical tool to guide interventions in the NICU setting.
AB - Abstract: Infants requiring admission to the neonatal intensive care unit (NICU) are particularly vulnerable to developing brain injury. The severity of the underlying clinical conditions and the complexity of care call for continuous, cot-side, non-invasive monitoring tools. Near-infrared spectroscopy (NIRS) measures the regional tissue oxygen saturation of hemoglobin (rStO2) and provides continuous information on the net-result of several factors. Cerebral rStO2 correlates with echocardiography-derived measures of blood flow. Cerebral fractional tissue oxygen extraction provides information on the balance between oxygen supply and demand and can be continuously derived from the combined use of cerebral rStO2 and arterial oxygen saturation. Information on cerebral blood flow autoregulatory capacity can be obtained from combining cerebral rStO2 and invasive blood pressure monitoring by appropriate software. Cerebral rStO2 provides real-time, end-organ information on perfusion-oxygenation, and when interpreted in the clinical context based on pathophysiological principles may be used as a help to guide interventions in the NICU. In this review we will discuss how to optimize NIRS monitoring for application in the NICU, with a particular focus on the preterm infant. Impact: Near-infrared spectroscopy (NIRS) provides cot-side, real-time information on blood and oxygen supply to the brain. Therefore, it is a valuable tool to better understand the pathophysiology underlaying disease processes. Current evidence suggests that NIRS-guided treatment in extremely preterm infants during transitional circulation does not improve clinical outcomes. Specific training is needed to maximize potential performance. Pathophysiological interpretation of cerebral NIRS data in the given clinical context may help in decision-making. Appropriate use of this monitoring technique, interpreted concurrently with other routine parameters, is a potential clinical tool to guide interventions in the NICU setting.
U2 - 10.1038/s41390-024-03649-8
DO - 10.1038/s41390-024-03649-8
M3 - Review
AN - SCOPUS:85208593318
SN - 0031-3998
JO - Pediatric Research
JF - Pediatric Research
ER -