Advances in Near-Infrared Spectroscopy to Study the Brain of the Preterm and Term Neonate
Section snippets
Material and methods
The authors searched for papers on the database MEDLINE (PubMed) using the keywords: “near-infrared,” “neonate” for cerebral autoregulation, blood volume, flow and oxygenation and “near-infrared spectroscopy,” “neonate” and “brain” for brain activity up to May 2009. The references were screened and the full texts of relevant publications were retrieved. For non-English articles, the review was limited to the abstract. The review of instruments was restricted to NIRS oximetry and/or NIRI
Instrumentation
NIRS instruments are mostly portable, and with the rapid development of optics and electronics have become increasingly economical and robust.
In brief, measurement of deep tissues is made possible by the relative transparency of tissue in the range of wavelengths from 700 to 1000 nm, called the near-infrared (NIR) window. At shorter wavelengths, in the visible spectrum, the chromophore hemoglobin absorbs strongly and prevents a deeper look. At longer wavelengths, water absorbs increasingly. In
Assessment of neonatal brain activity by NIRS/NIRI
One important application of NIRS/NIRI is to study activity and function of the brain and its development. For this purpose, specific stimuli are applied and the response of the brain is recorded. Two types of optical signals associated with brain activity can be detected by NIRS/NIRI: the neuronal signal, which occurs within milliseconds and reflects optical changes in the neuron, and the hemodynamic signal, which occurs within seconds and is associated with an increase in blood flow to the
Summary
Near-infrared spectrometry (NIRS) and imaging (NIRI) to study preterm and newborn infants are reviewed. Two main applications of NIRS and NIRI are discussed:
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The measurement of cerebral autoregulation, blood volume, flow, and oxygenation. Here the future aim is to safeguard the brain by adjusting the blood and oxygen supply to the brain to adequate levels and to prevent brain lesions. For this purpose, instrumentation, which provides absolute values of tissue oxygenation is available and
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Relation of cerebral tissue oxygenation index to central venous oxygen saturation in children
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Near-infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients
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Near-infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation
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Left-to-right differences of regional cerebral oxygen saturation and oxygen extraction in preterm infants during the first days of life
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Precision of measurement of cerebral tissue oxygenation index using near-infrared spectroscopy in preterm neonates
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Research on the relationship between brain anoxia at different regional oxygen saturations and brain damage using near-infrared spectroscopy
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Neonatal intensive care: an obvious yet difficult area for near infrared spectroscopy
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For this review no specific funding was received.