Regional tissue oxygenation monitoring in the neonatal intensive care unit: evidence for clinical strategies and future directions.
Pediatr Res
; 86(3): 296-304, 2019 09.
Article
em En
| MEDLINE
| ID: mdl-31247635
ABSTRACT
Near-infrared spectroscopy (NIRS)-based monitoring of regional tissue oxygenation (rSO2) is becoming more commonplace in the neonatal intensive care unit (NICU). While increasing evidence supports rSO2 monitoring, actual standards for applying this noninvasive bedside technique continue to evolve. This review highlights the current strengths and pitfalls surrounding practical NIRS-based monitoring in the neonatal population. The physiologic background of rSO2 monitoring is discussed, with attention to understanding oxygen delivery/consumption mismatch and its effects on tissue oxygen extraction. The bedside utility of both cerebral and peripheral rSO2 monitoring in the NICU is then explored from two perspectives (1) disease/event-specific "responsive" monitoring and (2) "routine," continuous monitoring. Recent evidence incorporating both monitoring approaches is summarized with emphasis on practical applicability in the NICU. Finally, a future paradigm for a broad-based NIRS monitoring strategy is presented, with attention towards improving personalization of neonatal care and ultimately enhancing long-term outcomes.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
5_ODS3_mortalidade_materna
Base de dados:
MEDLINE
Assunto principal:
Oximetria
/
Unidades de Terapia Intensiva Neonatal
/
Terapia Intensiva Neonatal
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Espectroscopia de Luz Próxima ao Infravermelho
/
Monitorização Fisiológica
Tipo de estudo:
Diagnostic_studies
/
Guideline
Limite:
Humans
/
Newborn
Idioma:
En
Revista:
Pediatr Res
Ano de publicação:
2019
Tipo de documento:
Article