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


CONCLUSIONS
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.
Division of Neonatology, and Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics, Medical University, Graz, Austria.
Nina
N
Höller
Berndt
B
Urlesberger
Lukas
L
Mileder
Nariae
N
Baik
Bernhard
B
Schwaberger
Gerhard
G
Pichler
D001921:Brain / Q000098:blood supply*; D006801:Humans; D007231:Infant, Newborn; D009130:Muscle, Smooth / Q000098:blood supply*; D010092:Oximetry; D010100:Oxygen; D010477:Perfusion; D019265:Spectroscopy, Near-Infrared
D010100:Oxygen