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Children
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Application of Near-Infrared Spectroscopy in Pediatrics
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Application of Near-Infrared Spectroscopy in Pediatrics

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: 1 February 2025 | Viewed by 6462

Special Issue Editor

Dr. Elisabeth M. W. Kooi

E-Mail Website
Guest Editor
Beatrix Children's Hospital, Neonatology, University of Groningen | RUG, Groningen, The Netherlands
Interests: neonatal oxygenation; neonatal hemodynamics; near-infrared spectroscopy; necrotizing enterocolitis; cerebrovascular autoregulation

Special Issue Information

Dear Colleagues,

Near-infrared spectroscopy (NIRS) allows for non-invasive assessment of end-organ oxygenation, making this technique especially suitable for neonates and children. Multiple NIRS applications have been described with regard to various neonatal and pediatric populations with various illnesses, and assessing multiple organs. The assessment of cerebral oxygenation has been studied widely, though evidence for effective clinical use in the pediatric population is still scarce. Using NIRS for the assessment for cerebrovascular autoregulation is gaining interest. Similarly, functional cerebral NIRS may add valuable information on cerebral perfusion to other neuroimaging techniques in children. For somatic use, the measurement of renal, intestinal, lung or muscle tissue oxygen saturation may potentially allow for the prediction of diseases or the efficacy and complications of therapy, as often seen in small cohorts. However, signal processing may be required prior to clinical application, and firm evidence for improved clinical outcomes when using somatic NIRS is still lacking. For this series of papers, we plan to include original research and review papers on the application of both cerebral and somatic NIRS in the neonatal and pediatric populations.

Dr. Elisabeth M. W. Kooi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • near-infrared spectroscopy
  • neonatal/pediatric hemodynamics
  • oxygenation
  • functional NIRS
  • tissue oxygen saturation
  • cerebral autoregulation
  • hypoxic-ischemic
  • neonate/child

Published Papers (5 papers)

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7 pages, 495 KiB  
Article
Decreased Intraoperative Renal Tissue Oxygenation after Cardiopulmonary Bypass Predicts Cardiac Surgery-Associated Acute Kidney Injury in Neonates
by Paige E. Condit, Daniel P. Gorski, Michael R. Lasarev, Awni M. Al-Subu and Matthew W. Harer
Children 2024, 11(3), 315; https://doi.org/10.3390/children11030315 - 07 Mar 2024
Viewed by 852
Abstract
(1) Background: Near-infrared spectroscopy (NIRS) is a noninvasive tool frequently used during cardiac surgery and postoperatively in the cardiac intensive care unit to monitor regional tissue oxygen saturation. A relationship between trends of intraoperative renal oxygenation and the risk of developing cardiac surgery-associated [...] Read more.
(1) Background: Near-infrared spectroscopy (NIRS) is a noninvasive tool frequently used during cardiac surgery and postoperatively in the cardiac intensive care unit to monitor regional tissue oxygen saturation. A relationship between trends of intraoperative renal oxygenation and the risk of developing cardiac surgery-associated acute kidney injury (AKI) post-operatively has not yet been established in the neonatal population. The objective of this study is to evaluate the relationship of cerebral and renal oxygenation during cardiopulmonary bypass with cardiac surgery-associated AKI in the first 72 h post-operation in neonates < 30 days of age. (2) Methods: A prospective cohort study at a tertiary care children’s hospital was performed. Renal and cerebral oxygenation measured were collected intraoperatively from neonates < 30 days of age who underwent cardiopulmonary bypass for the correction of congenital heart disease. AKI was defined accordance with the Kidney Disease: Improving Global Outcomes criteria modified for neonates. Variables were compared between groups. (3) Results: 32 neonates with 35 cardiopulmonary bypass cases were included. AKI was diagnosed in 60% of cases. Intra-operative renal oxygenation, both on- and off-bypass, did not differ among the three AKI groups (p > 0.19). Renal oxygenation after coming off, but not during, cardiopulmonary bypass steadily decreased with increasing levels of AKI (Jonckheere’s test, one-sided p = 0.024). (4) Conclusions: Renal oxygenation decreased in proportion to AKI severity after coming off, but not during, cardiopulmonary bypass. Full article
(This article belongs to the Special Issue Application of Near-Infrared Spectroscopy in Pediatrics)
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17 pages, 3436 KiB  
Article
Habit-DisHabit Design with a Quadratic Equation: A Better Model of the Hemodynamic Changes in Preschoolers during the Dimension Change Card Sorting Task
by Dandan Wu, Chunqi Chang, Jinfeng Yang, Jiutong Luo, Sha Xie and Hui Li
Children 2023, 10(9), 1574; https://doi.org/10.3390/children10091574 - 19 Sep 2023
Viewed by 1277
Abstract
General linear modeling (GLM) has been widely employed to estimate the hemodynamic changes observed by functional near infrared spectroscopy (fNIRS) technology, which are found to be nonlinear rather than linear, however. Therefore, GLM might not be appropriate for modeling the hemodynamic changes evoked [...] Read more.
General linear modeling (GLM) has been widely employed to estimate the hemodynamic changes observed by functional near infrared spectroscopy (fNIRS) technology, which are found to be nonlinear rather than linear, however. Therefore, GLM might not be appropriate for modeling the hemodynamic changes evoked by cognitive processing in developmental neurocognitive studies. There is an urgent need to identify a better statistical model to fit into the nonlinear fNIRS data. This study addressed this need by developing a quadratic equation model to reanalyze the existing fNIRS data (N = 38, Mage = 5.0 years, SD = 0.69 years, 17 girls) collected from the mixed-order design Dimensional Change Card Sort (DCCS) task and verified the model with a new set of data with the Habit-DisHabit design. First, comparing the quadratic and cubic modeling results of the mixed-order design data indicated that the proposed quadratic equation was better than GLM and cubic regression to model the oxygenated hemoglobin (HbO) changes in this task. Second, applying this quadratic model with the Habit-DisHabit design data verified its suitability and indicated that the new design was more effective in identifying the neural correlates of cognitive shifting than the mixed-order design. These findings jointly indicate that Habit-DisHabit Design with a quadratic equation might better model the hemodynamic changes in preschoolers during the DCCS task. Full article
(This article belongs to the Special Issue Application of Near-Infrared Spectroscopy in Pediatrics)
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11 pages, 1534 KiB  
Article
Comparison of Near-Infrared Spectroscopy-Based Cerebral Autoregulatory Indices in Extremely Low Birth Weight Infants
by Howard Chao, Sebastian Acosta, Craig Rusin and Christopher Rhee
Children 2023, 10(8), 1361; https://doi.org/10.3390/children10081361 - 09 Aug 2023
Viewed by 1042
Abstract
Background: Premature infants are born with immature cerebral autoregulation function and are vulnerable to pressure passive cerebral circulation and subsequent brain injury. Measurements derived from near-infrared spectroscopy (NIRS) have enabled continuous assessment of cerebral vasoreactivity. Although NIRS has enabled a growing field of [...] Read more.
Background: Premature infants are born with immature cerebral autoregulation function and are vulnerable to pressure passive cerebral circulation and subsequent brain injury. Measurements derived from near-infrared spectroscopy (NIRS) have enabled continuous assessment of cerebral vasoreactivity. Although NIRS has enabled a growing field of research, the lack of clear standardization in the field remains problematic. A major limitation of current literature is the absence of a comparative analysis of the different methodologies. Objectives: To determine the relationship between NIRS-derived continuous indices of cerebral autoregulation in a cohort of extremely low birth weight (ELBW) infants. Methods: Premature infants of birth weight 401–1000 g were studied during the first 72 h of life. The cerebral oximetry index (COx), hemoglobin volume index (HVx), and tissue oxygenation heart rate reactivity index (TOHRx) were simultaneously calculated. The relationship between each of the indices was assessed with Pearson correlation. Results: Fifty-eight infants with a median gestational age of 25.8 weeks and a median birth weight of 738 g were included. Intraventricular hemorrhage (IVH) was detected in 33% of individuals. COx and HVx demonstrated the highest degree of correlation, although the relationship was moderate at best (r = 0.543, p < 0.001). No correlation was found either between COx and TOHRx (r = 0.318, p < 0.015) or between HVx and TOHRx (r = 0.287, p < 0.029). No significant differences in these relationships were found with respect to IVH and no IVH in subgroup analysis. Conclusions: COx, HVx, and TOHRx are not numerically equivalent. Caution must be applied when interpreting or comparing results based on different methodologies for measuring cerebral autoregulation. Uniformity regarding data acquisition and analytical methodology are needed to firmly establish a gold standard for neonatal cerebral autoregulation monitoring. Full article
(This article belongs to the Special Issue Application of Near-Infrared Spectroscopy in Pediatrics)
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13 pages, 1698 KiB  
Article
Machine Learning Detects Intraventricular Haemorrhage in Extremely Preterm Infants
by Minoo Ashoori, John M. O’Toole, Ken D. O’Halloran, Gunnar Naulaers, Liesbeth Thewissen, Jan Miletin, Po-Yin Cheung, Afif EL-Khuffash, David Van Laere, Zbyněk Straňák, Eugene M. Dempsey and Fiona B. McDonald
Children 2023, 10(6), 917; https://doi.org/10.3390/children10060917 - 23 May 2023
Cited by 1 | Viewed by 1526
Abstract
Objective: To test the potential utility of applying machine learning methods to regional cerebral (rcSO2) and peripheral oxygen saturation (SpO2) signals to detect brain injury in extremely preterm infants. Study design: A subset of infants enrolled in the Management [...] Read more.
Objective: To test the potential utility of applying machine learning methods to regional cerebral (rcSO2) and peripheral oxygen saturation (SpO2) signals to detect brain injury in extremely preterm infants. Study design: A subset of infants enrolled in the Management of Hypotension in Preterm infants (HIP) trial were analysed (n = 46). All eligible infants were <28 weeks’ gestational age and had continuous rcSO2 measurements performed over the first 72 h and cranial ultrasounds performed during the first week after birth. SpO2 data were available for 32 infants. The rcSO2 and SpO2 signals were preprocessed, and prolonged relative desaturations (PRDs; data-driven desaturation in the 2-to-15-min range) were extracted. Numerous quantitative features were extracted from the biosignals before and after the exclusion of the PRDs within the signals. PRDs were also evaluated as a stand-alone feature. A machine learning model was used to detect brain injury (intraventricular haemorrhage-IVH grade II–IV) using a leave-one-out cross-validation approach. Results: The area under the receiver operating characteristic curve (AUC) for the PRD rcSO2 was 0.846 (95% CI: 0.720–0.948), outperforming the rcSO2 threshold approach (AUC 0.593 95% CI 0.399–0.775). Neither the clinical model nor any of the SpO2 models were significantly associated with brain injury. Conclusion: There was a significant association between the data-driven definition of PRDs in rcSO2 and brain injury. Automated analysis of PRDs of the cerebral NIRS signal in extremely preterm infants may aid in better prediction of IVH compared with a threshold-based approach. Further investigation of the definition of the extracted PRDs and an understanding of the physiology underlying these events are required. Full article
(This article belongs to the Special Issue Application of Near-Infrared Spectroscopy in Pediatrics)
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15 pages, 2128 KiB  
Systematic Review
Insights into Neonatal Cerebral Autoregulation by Blood Pressure Monitoring and Cerebral Tissue Oxygenation: A Qualitative Systematic Review
by Daniel Pfurtscheller, Nariae Baik-Schneditz, Bernhard Schwaberger, Berndt Urlesberger and Gerhard Pichler
Children 2023, 10(8), 1304; https://doi.org/10.3390/children10081304 - 28 Jul 2023
Viewed by 837
Abstract
Objective: The aim of this qualitative systematic review was to identify publications on blood pressure monitoring in combination with cerebral tissue oxygenation monitoring during the first week after birth focusing on cerebral autoregulation. Methods: A systematic search was performed on PubMed. The following [...] Read more.
Objective: The aim of this qualitative systematic review was to identify publications on blood pressure monitoring in combination with cerebral tissue oxygenation monitoring during the first week after birth focusing on cerebral autoregulation. Methods: A systematic search was performed on PubMed. The following search terms were used: infants/newborn/neonates, blood pressure/systolic/diastolic/mean/MAP/SAP/DAP, near-infrared spectroscopy, oxygenation/saturation/oxygen, and brain/cerebral. Additional studies were identified by a manual search of references in the retrieved studies and reviews. Only human studies were included. Results: Thirty-one studies focused on preterm neonates, while five included preterm and term neonates. In stable term neonates, intact cerebral autoregulation was shown by combining cerebral tissue oxygenation and blood pressure during immediate transition, while impaired autoregulation was observed in preterm neonates with respiratory support. Within the first 24 h, stable preterm neonates had reduced cerebral tissue oxygenation with intact cerebral autoregulation, while sick neonates showed a higher prevalence of impaired autoregulation. Further cardio-circulatory treatment had a limited effect on cerebral autoregulation. Impaired autoregulation, with dependency on blood pressure and cerebral tissue oxygenation, increased the risk of intraventricular hemorrhage and abnormal neurodevelopmental outcomes. Conclusions: Integrating blood pressure monitoring with cerebral tissue oxygenation measurements has the potential to improve treatment decisions and optimizes neurodevelopmental outcomes in high-risk neonates. Full article
(This article belongs to the Special Issue Application of Near-Infrared Spectroscopy in Pediatrics)
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