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Nirs neonates

Anna Schneider, Edda Hofstätter, Johannes Brandner, Angelika Moder, Silke Häusler, Martin Wald
BACKGROUND: Using near-infrared spectroscopy (NIRS) mixed tissue saturation can be calculated by measuring the oxygen saturation of oxygenated and deoxygenated erythrocytes in the tissue. Quality of the calculated value is not only dependent on the exposure of the measured values in the calculation, but also on external factors such as artifacts. Main object of this study was to determine whether and how the measurement quality of different devices varies in their long-term use in premature infants...
March 14, 2018: Klinische Pädiatrie
Rajiv R Iyer, Carolyn M Carey, S Alex Rottgers, Lisa Tetreault, Nir Shimony, Jennifer Katzenstein, Ernesto Ruas, Gerald F Tuite
OBJECTIVE Infants with severe hydrocephalus and extreme macrocephaly typically undergo CSF diversion early in life, which can result in significant cranial deformity due to CSF overdrainage. In this scenario, overlap of the cranial plates can precede the development of secondary synostosis and/or severe, permanent cranial deformity. As a result, extensive cranial vault remodeling is sometimes undertaken later in life, which is often challenging and has been associated with mortality and a high morbidity rate...
March 2, 2018: Journal of Neurosurgery. Pediatrics
Ryo Shirotsuki, Hiroo Uchida, Yujiro Tanaka, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Akinari Hinoki, Kazuo Oshima, Kosuke Chiba, Wataru Sumida, Masahiro Hayakawa, Takahisa Tainaka
BACKGROUND: Postoperative chylothorax after surgery for esophageal atresia/tracheoesophageal fistula (TEF) is a rare but serious complication, especially in neonates. This study aimed to identify the thoracic duct and ligate chylous leakage sites, using thoracoscopic navigation of an indocyanine-green (ICG)-based near-infrared (NIR) fluorescence imaging system. METHODS: From November 2014 to April 2017, thoracoscopic intraoperative ICG-NIR imaging was performed in 10 newborns (11 surgeries) with first TEF operation or with persistent postoperative chylothorax after TEF operation...
February 1, 2018: Journal of Pediatric Surgery
Silvia Martini, Luigi Corvaglia
Near infrared spectroscopy (NIRS) provides a non-invasive, continuous monitoring of regional tissue oxygenation. NIRS assessment of neonatal splanchnic oxygenation (SrSO2 ) has gained increasing interest over the last decade, as local hypoxia and ischemia underlie the most feared gut complications in neonates. Current literature provides encouraging evidence in support of SrSO2 reliability in detecting mesenteric hemodynamic changes related to various physiological and pathological conditions in-term and preterm infants...
February 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Gerhard Pichler, Nina Höller, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Jasmin Stadler, Alexander Avian, Jasmin Pansy, Berndt Urlesberger
Introduction: Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates. Study design: Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study...
2018: Frontiers in Pediatrics
Carol Lu Hunter, Ju Lee Oei, Keiji Suzuki, Kei Lui, Timothy Schindler
AIM: To assess uptake and applications of near-infrared spectroscopy (NIRS) by neonatal intensive care units (NICUs). METHODS: A pre-piloted online questionnaire was distributed in May 2015 to 12 perinatal societies in Asia, Europe, Australasia, North America and Middle East for dissemination to NICUs. Questions surveyed demographics, NIRS research/clinical applications, usage frequency, training approaches and target infant populations. RESULTS: In total, 255 responses from 235 NICUs were obtained...
February 11, 2018: Acta Paediatrica
Nan Lin, John Flibotte, Daniel J Licht
Utilization of extraocorporeal membrane oxygenation (ECMO) has become increasingly widespread as a bridging therapy for neonates with severe, reversible respiratory or cardiac diseases. While significant risks remain, due to advances in medical and surgical management, overall mortality has decreased. However, short and long-term neurological morbidity has remained high. Therefore, increasing attention has been focused on multimodal neuromonitoring to track and optimally, minimize or prevent intracranial injury...
February 2, 2018: Seminars in Perinatology
Aisling A Garvey, Eugene M Dempsey
PURPOSE OF REVIEW: There has been a significant increase in the utilization of NIRS in neonatal care over the last few years, with some centers now routinely utilizing this monitoring technique for direct intervention at the bedside. In this review, we provide a summary of the most up-to-date evidence on near infrared spectroscopy utilization, with particular emphasis on measurement of cerebral oxygenation in preterm infants. RECENT FINDINGS: There have been significant advances in the technology, leading to an increase in the number of available devices and in the use of this monitoring tool to reduce cerebral injury in preterm infants...
January 22, 2018: Current Opinion in Pediatrics
J C Pérez Moreno, D C Nájera Losada, P Sanabria Carretero, Á Paredes Lacave, F Benito Bartolomé
Transposition of the great arteries (D-TGA) is one of the most common congenital heart diseases requiring neonatal surgical intervention. In the desperately ill neonate with TGA and the resultant hypoxaemia, acidemia, and congestive heart failure, improvement is often obtained with balloon atrial septostomy (BAS). Current methods employed to evaluate oxygen delivery and tissue consumption are frequently nonspecific. Near infrared spectroscopy (NIRS) allows a continuous non-invasive measurement of tissue oxygenation which reflects perfusion status in real time...
January 21, 2018: Revista Española de Anestesiología y Reanimación
S Kleiser, D Ostojic, B Andresen, N Nasseri, H Isler, F Scholkmann, T Karen, G Greisen, M Wolf
Cerebral near-infrared spectroscopy (NIRS) oximetry may help clinicians to improve patient treatment. However, the application of NIRS oximeters is increasingly causing confusion to the users due to the inconsistency of tissue oxygen haemoglobin saturation (StO 2 ) readings provided by different oximeters. To establish a comparability of oximeters, in our study we performed simultaneous measurements on the liquid phantom mimicking properties of neonatal heads and compared the tested device to a reference NIRS oximeter (OxiplexTS)...
January 1, 2018: Biomedical Optics Express
Eman Alsayegh, Jon Barrett, Nir Melamed
BACKGROUND: Administrating a single course of antenatal corticosteroids to women at risk of preterm birth between 24 and 34 weeks of gestation has been shown to decrease neonatal morbidity and mortality. There is evidence that the optimal timing for the administration of antenatal corticosteroids is within 1-7 days before birth as the effect of antenatal corticosteroids has been shown to decline 7 days after administration. Therefore, given that antenatal corticosteroids are the single most effective intervention in cases of preterm birth, efforts should be made to optimize the timing of administration of antenatal corticosteroids...
January 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
Eric B Ortigoza, Jackson Cagle, Jui-Hong Chien, Sungho Oh, L Steven Brown, Josef Neu
OBJECTIVES: To obtain objective measures indicative of gastrointestinal maturity using three non-invasive technologies. METHODS: Electrogastrography (EGG), abdominal near-infrared spectroscopy (NIRS), and bowel sound/acoustics (AC) monitoring were used simultaneously to obtain physiologic measures of the gastrointestinal system of 18 preterm and 5 term neonates who were tolerating enteral feedings.Measures of EGG slow wave voltage (EGG dominant power) and AC signal amplitude (AC dominant power) were obtained after spectral density analysis...
December 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
Lukas Peter Mileder, Tessa Mueller, Nariae Baik-Schneditz, Jasmin Pansy, Bernhard Schwaberger, Corinna Binder-Heschl, Berndt Urlesberger, Gerhard Pichler
In neonates, a patent ductus arteriosus (DA) may be associated with severe complications. We used near-infrared spectroscopy (NIRS) with venous occlusion to investigate the influence of an open DA on peripheral muscle oxygenation/perfusion in preterm neonates. Approach: We analyzed secondary outcome parameters collected as part of prospective observational studies. NIRS measurements were performed between the first and third day of life. Arterial oxygen saturation (SaO2) and heart rate (HR) were monitored by pulse oximetry on the ipsilateral foot...
November 21, 2017: Physiological Measurement
Stephanie M Cruz, Patricio E Lau, Craig G Rusin, Candace C Style, Darrell L Cass, Caraciolo J Fernandes, Timothy C Lee, Christopher J Rhee, Sundeep Keswani, Rodrigo Ruano, Stephen E Welty, Oluyinka O Olutoye
BACKGROUND/PURPOSE: The purpose of this study was to develop a computational algorithm that would predict the need for ECMO in neonates with congenital diaphragmatic hernia (CDH). METHODS: CDH patients from August 2010 to 2016 were enrolled in a study to continuously measure cerebral tissue oxygen saturation (cStO2) of left and right cerebral hemispheres. NIRS devices utilized were FORE-SIGHT, CASMED and INVOS 5100, Somanetics. Using MATLAB©, a data randomization function was used to deidentify and blindly group patient's data files as follows: 12 for the computational model development phase (6 ECMO and 6 non-ECMO) and the remaining patients for the validation phase...
October 12, 2017: Journal of Pediatric Surgery
Katherine Braski, Kimberlee Weaver-Lewis, Manndi Loertscher, Qian Ding, Xiaoming Sheng, Mariana Baserga
BACKGROUND: Anemia is common in premature infants. Due to risks with red blood cell transfusions, many anemic infants are not transfused. The implications of this pathophysiologic status, especially at times of increased metabolic demand (enteral feedings), is not well understood. Near-infrared spectroscopy (NIRS) allows for the noninvasive determination of regional oxygen saturations (rSO2) in tissues such as the brain and mesentery, giving insight into their oxygen sufficiency. OBJECTIVE: We tested the hypothesis that during enteral feedings very low birth weight (VLBW) infants with a hematocrit ≤28% will experience a decrease in splanchnic rSO2 and splanchnic-cerebral oxygenation ratio (SCOR)...
2018: Neonatology
C Sola, L Hertz, S Bringuier, P De La Arena, C Macq, S Deziel-Malouin, O Raux, C Dadure
Background: Spinal Anaesthesia (SA) has been firmly established as an efficient and safe technique, with minimal cardio-respiratory disturbance when administered in the neonatal period. Our objective was to assess the haemodynamic consequences of SA in infants, particularly its impact on cerebral perfusion using near-infrared spectroscopy (NIRS)-based cerebral oximetry (rSco2). Methods: All infants up to 60 weeks' postmenstrual age, whether formerly preterm or not, and undergoing spinal anaesthesia, were enrolled...
November 1, 2017: British Journal of Anaesthesia
Agnieszka Wlodarczyk, Inge R Holtman, Martin Krueger, Nir Yogev, Julia Bruttger, Reza Khorooshi, Anouk Benmamar-Badel, Jelkje J de Boer-Bergsma, Nellie A Martin, Khalad Karram, Isabella Kramer, Erik Wgm Boddeke, Ari Waisman, Bart Jl Eggen, Trevor Owens
Microglia are resident macrophages of the central nervous system that contribute to homeostasis and neuroinflammation. Although known to play an important role in brain development, their exact function has not been fully described. Here, we show that in contrast to healthy adult and inflammation-activated cells, neonatal microglia show a unique myelinogenic and neurogenic phenotype. A CD11c+ microglial subset that predominates in primary myelinating areas of the developing brain expresses genes for neuronal and glial survival, migration, and differentiation...
November 15, 2017: EMBO Journal
Alice Grometto, Benedetta Pizzo, Maria Chiara Strozzi, Francesca Gazzolo, Diego Gazzolo
AIM: The effects of different milk and, or, administration regimens on cerebro-splanchnic perfusion are still a matter of debate. We investigated the effects of the bolus administration of breast milk or formula on cerebro-splanchnic oximetry, function and perfusion, assessed by near-infrared spectroscopy (NIRS). METHODS: This observational study of 30 infants fed with breast (n = 15) or formula (n = 15) milk, and matched for gestational age and birth weight, was carried out in the neonatal intensive care unit of the C Arrigo Children's Hospital, Alessandria, Italy, a tertiary-level referral centre, from October 2015 to December 2016...
September 27, 2017: Acta Paediatrica
Renée A Shellhaas, Joseph W Burns, Fauziya Hassan, Martha D Carlson, John D E Barks, Ronald D Chervin
Objectives: The neurological examination of critically ill neonates is largely limited to reflexive behavior. The exam often ignores sleep-wake physiology that may reflect brain integrity and influence long-term outcomes. We assessed whether polysomnography and concurrent cerebral near-infrared spectroscopy (NIRS) might improve prediction of 18-month neurodevelopmental outcomes. Methods: Term newborns with suspected seizures underwent standardized neurologic examinations to generate Thompson scores and had 12-hour bedside polysomnography with concurrent cerebral NIRS...
November 1, 2017: Sleep
Simon Hyttel-Sorensen, Gorm Greisen, Bodil Als-Nielsen, Christian Gluud
BACKGROUND: Cerebral injury and long-term neurodevelopmental impairment is common in extremely preterm infants. Cerebral near-infrared spectroscopy (NIRS) enables continuous estimation of cerebral oxygenation. This diagnostic method coupled with appropriate interventions if NIRS is out of normal range (that is cerebral oxygenation within the 55% to 85% range) may offer benefits without causing more harms. Therefore, NIRS coupled with appropriate responses to abnormal findings on NIRS needs assessment in a systematic review of randomised clinical trials and quasi-randomised studies...
September 4, 2017: Cochrane Database of Systematic Reviews
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