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Updated: Dec 19, 2025
How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children
Published on: August 19, 2020
Changes in peripheral muscle oxygenation measured with near-infrared spectroscopy in preterm neonates within the
Christina Wolfsberger1,2, Nariae Baik-Schneditz1,2, Bernhard Schwaberger1,2
1Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Background:
Near-infrared spectroscopy (NIRS) combined with venous occlusions enables peripheral-muscle oxygenation and perfusion monitoring.
Objective:
The aim of the present exploratory observational study was to evaluate peripheral-muscle oxygenation and perfusion during the first 24 h after birth in stable preterm neonates.
Approach:
Secondary outcome parameters of prospective observational studies were analysed. Preterm neonates with peripheral-muscle NIRS measurements combined with venous occlusion on the first day after birth were included. Neonates without circulatory support and without signs of infection/inflammation were included. Neonates were stratified in four groups according to their measurement time-point (6 h-periods) and matched 2:1 for gestational age ±1 week. For each group haemoglobin flow (Hbflow), oxygen-delivery (DO2), oxygen-consumption (VO2), fractional-oxygen-extraction (FOE), tissue-oxygenation-index (TOI) and mixed-venous-oxygenation (SvO2) were calculated. Neonates with measurements during the first 6-hour time period were compared to neonates with measurements of the following time periods.
Main Results:
40 preterm neonates (gestational age (median(IQR)): 33.5(32.5-34.1)weeks) measured during the first 6 h period after birth were compared to 20 preterm neonates measured in each of the following 6 h periods (period two: 33.7(33.1-34.3)weeks; period three: 34.1(33.2-34.6)weeks; period four: 33.8(32.6-34.6)weeks). Hbflow, DO2 and SvO2 were significantly higher in the second and third 6 h time period compared to the first 6 h period. VO2 did not change significantly during the first day after birth. FOE was significantly lower in the second, third and fourth time period compared to the first 6 h period. TOI showed a non-significant trend towards higher values in the third period compared to the first 6 h period.
Significance:
In preterm neonates Hbflow, DO2, SvO2 increased, FOE decreased and TOI showed a trend towards increase during the first day after birth, whereas VO2 did not change. Changes of peripheral-muscle oxygenation during the first day after birth in stable preterm neonates are different to already published changes thereafter.
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