Abstract
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.
Highlights
History, Physics, and Physiology of Near-Infrared SpectroscopyNear-infrared energy exists in the 700–1,000 nm wavelength spectrum and was first discovered by the German astronomer William Herschel in the 19th century [1]
Jobsis et al applied the principles of near-infrared spectroscopy (NIRS) to medical research in the 1970s and demonstrated that NIRS could monitor regional cerebral blood flow because light wavelengths in the near-infrared range are uniquely suitable to measuring conformational changes in hemoglobin [2, 3]
This review provides a summary (Table 1) of the potential applications of NIRS in the neonatal intensive care unit (NICU)
Summary
Near-infrared energy exists in the 700–1,000 nm wavelength spectrum and was first discovered by the German astronomer (and composer) William Herschel in the 19th century [1]. Deoxyhemoglobin exists in a tense, low-oxygen affinity state. NIRS sensors measure the absorbance of light at wavelengths 700/850 nm, where the near-infrared absorption spectra are maximally separated between oxyhemoglobin and deoxyhemoglobin [7]. NIRS probes generally consist of a single light source (emitting light at two infrared wavelengths) and two down-stream photoreceptors, which measure light absorbance at different tissue depths [10]. Absorption of near-infrared light is relatively low and has been detected at depths of several centimeters of biologic tissue [11]. NIRS in Extremely Preterm Infants for light absorbed by the deoxyhemoglobin and oxyhemoglobin. The NIRS computer calculates a tissue-specific rSO2 at a tissue depth of 1–2 cm for the entire microcirculation. Unlike SvO2, which requires central venous monitoring to measure, rSO2 can be measured non-invasively using NIRS probes
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