Abstract
Cerebral oxygenation is not always reflected by systemic arterial oxygenation. Therefore, regional cerebral oxygen saturation (rScO2) monitoring with near-infrared spectroscopy (NIRS) is of added value in neonatal intensive care. rScO2 represents oxygen supply to the brain, while cerebral fractional tissue oxygen extraction, which is the ratio between rScO2 and systemic arterial oxygen saturation, reflects cerebral oxygen utilization. The balance between oxygen supply and utilization provides insight in neonatal cerebral (patho-)physiology. This review highlights the potential and limitations of cerebral oxygenation monitoring with NIRS in the neonatal intensive care unit.
Highlights
It has been nearly 8 years, since our research group published a review on the value and pitfalls of cerebral oxygenation monitoring with near-infrared spectroscopy (NIRS) in neonatology [1]
The data are converted into reference curves stratified for different gestational age (GA) which can be used for cot side interpretation of regional cerebral oxygen saturation (rScO2) and Cerebral fractional tissue oxygen extraction (cFTOE) values, as shown in Figure 1B [29]
High cerebral oxygenation with an abnormal amplitude-integrated electro-encephalography (aEEG) background pattern in severely asphyxiated neonates with hypothermia treatment at 12 h of age has a positive predictive value of 91%, absence of these results in a negative predictive value of 100% [123]. These findings strongly suggest that NIRS monitoring of cerebral oxygenation can have an important role in the prognosis of neurodevelopmental outcome
Summary
It has been nearly 8 years, since our research group published a review on the value and pitfalls of cerebral oxygenation monitoring with near-infrared spectroscopy (NIRS) in neonatology [1]. Research into cerebral NIRS has taken an impressive flight. The importance of cerebral oxygenation and perfusion monitoring has been increasingly recognized in neonatal intensive care. The development of cerebral NIRS monitoring over the past years is summarized
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