Utility of Abdominal Near Infrared Spectroscopy in the Management of Neonates: A Review

Near-infrared spectroscopy (NIRS) is a noninvasive technique that utilizes light in the near-infrared spectrum to assess regional tissue oxygenation. The initial application of NIRS focused on measuring cerebral oxygenation. Recently, numerous studies focused on the utility of NIRS in measuring abdominal regional perfusion in preterm and full-term neonates-hepatic (right subcostal) and mesenteric (left lower quadrant/infra-umbilical probe). Abdominal NIRS, specifically the infraumbilical values obtained within the first week of life, is a useful tool for the evaluation of feeding intolerance and an early marker of the development of necrotizing enterocolitis (NEC) as changes in NIRS in the first 24 hours of abdominal symptoms helps define NEC severity. In addition, NIRS holds promise in identifying changes in abdominal regional perfusion with blood transfusion. The goal of this review is to summarize the current knowledge of factors affecting abdominal NIRS measurements, specifically alterations associated with feeding, blood transfusion, and necrotizing enterocolitis (NEC). We present information from the published clinical research in conjunction with information collected from an extensive search in the databases PubMed, EMBASE, and Scopus. · Abdominal NIRS is still an underutilized tool at the bedside in various clinical conditions.. · Compared with cerebral NIRS, splanchnic NIRS has more variability.. · Splanchnic NIRS can be used for clinical conditions such as feeding, blood transfusion, and NEC.. · There is a need for standardized algorithms in infants based on their GA and clinical diagnosis..