Author:
Polise Olivia,Newberry Desi
Abstract
Background:
Cerebral near-infrared spectroscopy (cNIRS) is a noninvasive technology used to trend cerebral perfusion at the bedside. cNIRS has potential as a valuable tool in the evaluation of infants with suspected hypoxic-ischemic encephalopathy (HIE). Trending cerebral perfusion with cNIRS can provide information regarding cerebral metabolism as HIE is evolving, which may offer insight into the extent of brain injury.
Purpose:
The purpose of this systematic review is to investigate the use of cNIRS as a neurocritical tool in the management of neonatal HIE by evaluating its ability to detect acute neurological compromise, including acute brain injury and seizure activity, as well as its potential to identify infants at high risk for long-term neurodevelopmental impairment.
Methods:
A literature search was conducted using PubMed, CINAHL, and Web of Science databases to review articles investigating cNIRS technology in the acute management of HIE.
Results:
Eight studies were identified and included in this systematic review. Correlations were observed between cNIRS trends and neurological outcomes as later detected by MRI. cNIRS has potential as a bedside neuromonitoring tool in the management of HIE to detect infants at high risk for brain injury.
Implications for Practice:
Existing research supports the value of trending cNIRS in HIE management. Documented normal cNIRS values for both term and preterm infants in the first few days of life is approximately 60% to 80%. A steadily increasing cNIRS reading above an infant's baseline and a value of more than 90% should prompt further evaluation and concern for significant neurological injury.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
General Medicine,Pediatrics, Perinatology and Child Health
Reference29 articles.
1. Neurodevelopmental outcome in survivors of hypoxic ischemic encephalopathy without cerebral palsy;Hayes;Eur J Pediatr,2018
2. Trends of neonatal hypoxic ischemic encephalopathy prevalence and associated risk factors in the United States, 2010-2018 [published online ahead of print June 8, 2022];Acun;Am J Obstet Gynecol
3. Hypoxic-ischemic encephalopathy: a review for the clinician;Douglas-Escobar;JAMA Pediatr,2015
4. Cooling for newborns with hypoxic ischaemic encephalopathy;Jacobs;Cochrane Database Syst Rev,2013
5. Correspondence regarding “Outcomes of preterm infants treated with hypothermia for hypoxic-ischemic encephalopathy.”;Bidegain;Early Hum Dev,2019