Peripheral Muscle Near-Infrared Spectroscopy in Neonates: Ready for Clinical Use? A Systematic Qualitative Review of the Literature

Abstract

Background: Peripheral muscle near-infrared spectroscopy (NIRS) measurements are of increasing interest especially in the care of critically ill patients. Objective: The aim was to perform a systematic qualitative review on peripheral muscle NIRS measurements in the clinical care of term and preterm neonates. Methods: A systematic search of PubMed and Ovid Embase was performed using the following terms: neonate, neonates, newborn, newborns, infant, infants, near-infrared spectroscopy, NIRS, oxygenation, perfusion, oxygen extraction, peripheral, tissue, muscle, calf, forearm and thigh. Additional articles were identified by a manual search of the cited references. Only human studies were included. Results: Twenty-one studies were identified to use peripheral muscle NIRS measurements as a single method, 17 studies combined cerebral and peripheral muscle NIRS measurements and 1 study used multi-site NIRS measurements in human neonates. Two randomized studies were identified. Two additional publications were included because they provided important general information about peripheral muscle NIRS measurements. Conclusion: In the care of critically ill neonates peripheral muscle NIRS measurements alone or in combination with cerebral or multi-site NIRS measurements provide useful additional information about peripheral circulation and oxygenation. This method is a promising tool in the recognition of early states of centralization (compensated shock) in this vulnerable group of patients. However, before this method can be used in the clinical routine it has to be tested as monitoring to guide interventions in further studies.

Application of near-infrared spectroscopy in extremely and very low birth weight infants for red blood cells transfusion

“…Данный метод позволяет оценить различия между показателями церебральной и периферической оксигенации [17,25]. В ряде исследований описано улучшение показателей тканевой оксигенации, определенных с помощью NIRS, после заместительной трансфузии ЭСК крови у недоношенных новорожденных [8,9,24,26]. В частности, в исследовании G. Sandal и соавт., в которое были включены 23 новорожденных О Р И Г И Н А Л Ь Н Ы Е С Т А Т Ь И гестационного возраста менее 30 недель с установленным диагнозом «анемия недоношенных», проводилась оценка изменений показателей тканевой оксигенации до и после гемотрансфузии [27].…”

Fetal Hemoglobin and Tissue Oxygenation Measured With Near-Infrared Spectroscopy—A Systematic Qualitative Review

“…Venous occlusion causes an increase in blood volume by interruption of venous (out) flow, whereas arterial (in) flow remains unaffected. Thus, the measured changes in oxygenated, reduced and total hemoglobin during venous occlusion are caused only by the arterial inflow and oxygen consumption of tissue (24).…”

Evolution of Muscular Oxygenation during a Walking Test in Preterm Children

“…NIRS technology has been previously used in neonate and premature to measure tissue oxygenation and perfusion in regions of interest, e.g. the brain, kidneys or peripheral muscles, in early states of shock (16). It has also been used in children with muscular pathologies and chronic heart disease, in whom different profiles of muscular oxygenation were evidenced, compared to healthy subjects (17,18).…”