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Measurement of gut oxygenation in the neonatal population using near-infrared spectroscopy: a clinical tool?
  1. Emilie Seager1,
  2. Catherine Longley1,
  3. Narendra Aladangady2,
  4. Jayanta Banerjee3,4
  1. 1 Paediatrics and Neonatal, Imperial College Healthcare NHS Trust, London, UK
  2. 2 Neonatal, Homerton University Hospital, London, UK
  3. 3 Neonatology, Imperial College Healthcare NHS Trust, London, UK
  4. 4 Imperial College London Institute of Clinical Sciences, London, UK
  1. Correspondence to Dr Jayanta Banerjee, Neonatology, Imperial College Healthcare NHS Trust, London W12 0HS, UK; jayanta.banerjee{at}


Context Near-infrared spectroscopy (NIRS) is a non-invasive bedside monitor of tissue oxygenation that may be a useful clinical tool in monitoring of gut oxygenation in newborn infants.

Objective To systematically review literature to determine whether NIRS is a reliable tool to monitor gut oxygenation on neonatal units.

Data sources PubMed and Embase databases were searched using the terms ‘neonate’, ‘preterm infants’, ‘NIRS’ and ‘gut oxygenation’ (2001–2018).

Study selection Studies were included if they met inclusion criteria (clinical trial, observational studies, neonatal population, articles in English and reviewing regional gut oxygen saturations) and exclusion criteria (not evaluating abdominal NIRS or regional oxygen saturations).

Data extraction Two authors independently searched PubMed and Embase using the predefined terms, appraised study quality and extracted from 30 studies the study design and outcome data.

Limitations Potential for publication bias, majority of studies were prospective cohort studies and small sample sizes.

Results Thirty studies were reviewed assessing the validity of abdominal NIRS and potential application in neonates. Studies reviewed assessed abdominal NIRS in different settings including normal neonates, bolus and continuous feeding, during feed intolerance, necrotising enterocolitis and transfusion with packed red cells. Several observational studies demonstrated how NIRS could be used in clinical practice.

Conclusions NIRS may prove to be a useful bedside tool on the neonatal unit, working alongside current clinical tools in the monitoring of newborn infants (preterm and term) and inform clinical management. We recommend further studies including randomised controlled trials looking at specific measurements and cut-offs for abdominal NIRS for use in further clinical practice.

  • neonatology
  • gastroenterology

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  • Contributors ES contributed to study design, screened search results, reviewed all included studies, drafted the initial manuscript, and reviewed and revised the manuscript. CL contributed to study design, reviewed all included studies, and reviewed and revised the manuscript. NA reviewed and revised the manuscript. JB conceptualised this systematic review, reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.

  • Patient consent for publication Not required.