Utility of abdominal near infrared spectroscopy (NIRS) in the management of neonates – A review.

Near-infrared spectroscopy (NIRS) is a non-invasive technique which utilizes light in the near infrared spectrum to assess regional tissue oxygenation. 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.