Clinical Application of Near-Infrared Spectroscopy in Neonates

The incidence of cerebral palsy has not decreased despite advances in neonatal care. Preterm infants are at a high risk of cerebral palsy. Moreover, preterm infants might experience permanent neurological sequelae due to injury in the preterm brain. Although the etiology of preterm brain injury is not fully understood, preterm brain injury is strongly associated with abnormal cerebral perfusion and oxygenation. Monitoring systemic blood pressure or arterial oxygen saturation using pulse oxi metry is not enough to guarantee proper cerebral perfusion or oxygenation. Early detection of improper cerebral perfusion can prevent irreversible cerebral damage. To decrease brain injury through the early detection of underperfusion and deoxy genation, other diagnostic modalities are needed. Nearinfrared spectroscopy can continuously and noninvasively monitor regional oxygen saturation (rSO 2 ), which reflects the perfusion and oxygenation status of tissues at bedside. Nearinfrared spectroscopy represents a balance between tissue oxygen supply and demand. Ce rebral rSO 2 monitoring has been used most frequently in neonatal cardiac surgery to monitor cerebral oxygenation and prevent hypoxic damage or shock. Recently, cerebral, renal, or splanchnic rSO 2 in neonates is frequently monitored. The progres sion of a disease, brain injury, and death can be prevented by detecting changes in rSO 2 values using nearinfrared spectroscopy. In this article, the basic principles, use fulness, and applications of nearinfrared spectroscopy in neonates are discussed.