Skip to main content
SpringerLink
Log in

Cerebral oxygen monitoring with near infrared spectroscopy: Clinical application to neonates

  • Medical Intelligence
  • Published:
Journal of Clinical Monitoring Aims and scope Submit manuscript

Abstract

Near infrared spectroscopy is a new noninvasive optical method for bedside monitoring of cerebral oxygenation. It uses differential absorbance of near infrared light to assess relative changes in the oxidation-reduction state of cytochrome aa3, as well as changes in the amounts of oxyhemoglobin, deoxyhemoglobin, and blood volume in the monitored field. Although this technique is applicable to all ages and sizes of patients and to multiple clinical settings, the majority of clinical studies to date have focused on the neonate. These studies have demonstrated its potential for advancing neonatal care and in understanding how diseases and therapies affect cerebral oxygenation. This paper reviews the near infrared spectroscopy technique and summarizes its potential applications in the field of neonatal intensive care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jobsis FF. Noninvasive infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science 1977;198:1264–1271

    Article  PubMed  CAS  Google Scholar 

  2. Jobsis-VanderVliet FF. Non-invasive, near infrared monitoring of cellular oxygen sufficiency in vivo. Adv Exp Med Biol 1985;191:833–842

    CAS  Google Scholar 

  3. Jobsis-VanderVliet FF, Fox E, Sugioka K. Monitoring of cerebral oxygenation and cytochrome aa3 redox state. Int Anesthesiol Clin 1987;25:209–230

    Article  PubMed  CAS  Google Scholar 

  4. Jobsis-VanderVliet FF, Piantadosi CA, Sylvia AL, et al. Near infrared monitoring of cerebral oxygen sufficiency. I. Spectra of cytochrome c oxidase. Neurol Res 1988;10:7–17

    PubMed  CAS  Google Scholar 

  5. Araki R, Nashimoto I. Multicomponent analysis of near infrared spectra of anesthetized rat head: (1) estimation of component spectra by principal component analysis. Adv Exp Med Biol 1989;248:3–10

    PubMed  CAS  Google Scholar 

  6. Wray S, Cope M, Delpy DT, et al. Characterization of the near infrared absorption spectra of cytochrome aa3 and haemoglobin for the non-invasive monitoring of cerebral oxygenation. Biochim Biophys Acta 1988;933:184–192

    Article  PubMed  CAS  Google Scholar 

  7. Piantadosi CA. Behavior of the copper band of cytochromec oxidase in rat brain during FC-43-for-blood substitution. Adv Exp Med Biol 1989;248:81–90

    PubMed  CAS  Google Scholar 

  8. Brazy JE, Lewis DV, Mitnick MH, et al. Noninvasive monitoring of cerebral oxygenation in preterm infants. Preliminary Observations. Pediatrics 1985;75:217–225

    PubMed  CAS  Google Scholar 

  9. Wickramasignhe YABD, Crowe J, Rolfe P. Optical method adaptable for cerebral monitoring in the newborn. Med Biol Eng Comput Proc 1985;23:468 (suppl part 1)

    Google Scholar 

  10. Delpy DT, Cope MC, Cady EB, et al. Cerebral monitoring in newborn infants by magnetic resonance and near infrared spectroscopy. Scand J Clin Lab Invest 1987;88:9–17 (suppl)

    Article  Google Scholar 

  11. Hazeki O, Tamura M. Quantitative analysis of hemoglobin oxygenation state of rat brain in situ by near-infrared spectrophotometry. J Appl Physiol 1988;64:796–802

    Article  PubMed  CAS  Google Scholar 

  12. Pryds O, Greisen G, Skov LL, et al. Carbon dioxiderelated changes in cerebral blood volume and cerebral blood flow in mechanically ventilated preterm neonates. Comparison of near infrared spectrophotometry and xenon clearance. Pediatr Res 1990;27:445–449

    Article  PubMed  CAS  Google Scholar 

  13. Edwards AD, Wyatt JS, Richardson C, et al. Effects of indomethacin on cerebral haemodynamics in very preterm infants. Lancet 1990;335:1491–1495

    Article  PubMed  CAS  Google Scholar 

  14. American National Standards for the Safe Use of Lasers. New York, NY, American National Standards Institute, Publication No. Z136.1, 1976

  15. Reynolds EOR, Wyatt JS, Azzopardi D, et al. New noninvasive methods for assessing brain oxygenation and haemodynamics. Br Med Bull 1988;44:1052–1075

    PubMed  CAS  Google Scholar 

  16. Wyatt JS, Cope M, Delpy DT, et al. Measurement of optical path length for cerebral near infrared spectroscopy in newborn infants. Dev Neurosci 1990;12:140–144

    Article  PubMed  CAS  Google Scholar 

  17. Delpy DT, Cope M, vande Zee P, et al. Estimation of optical pathlength through tissue by direct time of flight measurement. Phys Med Biol 1988;33:1433–1442

    Article  PubMed  CAS  Google Scholar 

  18. Wyatt JS, Cope M, Delpy DT, et al. Quantification of cerebral oxygenation and hemodynamics in sick newborn infants by near infrared spectrophotometry. Lancet 1986;II:1063–1066

    Article  Google Scholar 

  19. Wyatt JS, Edwards AD, Azzopardi D, et al. Magnetic resonance and near infrared spectroscopy for investigation of perinatal hypoxic-ischaemic brain injury. Arch Dis Child 1989;64:953–963

    Article  PubMed  CAS  Google Scholar 

  20. Chance B, Smith DS, Delivoria-Papadopoulos M, et al. New techniques for evaluating metabolic brain injury in newborn infants. Crit Care Med 1989;17:465–471

    Article  PubMed  CAS  Google Scholar 

  21. Edwards AD, Wyatt JS, Richardson C, et al. Cotside measurement of cerebral blood flow in ill newborn infants by near infrared spectroscopy. Lancet 1988;II:770–771

    Article  Google Scholar 

  22. Brazy JE, Lewis DV, Mitnick MH, et al. Monitoring of cerebral oxygenation in the intensive care nursery. Adv Exp Med Biol 1986;191:843–848

    Google Scholar 

  23. Chance B, Williams GR. Respiratory enzymes in oxidative phosphorylation. III. The steady state. J Biol Chem 1955:217:409–427

    PubMed  CAS  Google Scholar 

  24. Sylvia AL, Piantadosa CA, Jobsis FF. Energy metabolism and in vivo cytochrome c oxidase redox relationship in hypoxic rat brain. Neurol Res 1985;7:81–88

    PubMed  CAS  Google Scholar 

  25. Kariman K, Hemphel FG, Jobsis FF, et al. In vivo comparison of cerebral tissuePo 2 and cytochrome aa3 reduction-oxidation state in cats during hemorrhagic shock. J Clin Invest 1981;68:21–27

    Article  PubMed  CAS  Google Scholar 

  26. Brazy JE, Lewis DV. Changes in cerebral blood volume and cytochrome aa3 during hypertensive peaks in preterm infants. J Pediatr 1986;108:983–987

    Article  PubMed  CAS  Google Scholar 

  27. Brazy JE. Effects of crying on cerebral blood volume and cytochrome aa3. J Pediatr 1988;112:457–461

    Article  PubMed  CAS  Google Scholar 

  28. Sakai F, Nakazawa Y, Tazaki Y, et al. Regional cerebral blood volume and hematocrit measured in normal human volunteers by single-photon emission computed tomography. J Cereb Blood Flow Metab 1985;5:207–213

    PubMed  CAS  Google Scholar 

  29. Greisen G. Cerebral blood flow in preterm infants in the first week of life. Acta Paediatr Scand 1986;75:43–51

    Article  PubMed  CAS  Google Scholar 

  30. Volpe JJ, Hersovitch P, Perlman JM, et al. Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement. Pediatrics 1983;72:589–601

    PubMed  CAS  Google Scholar 

  31. Bryan RM, Jr, Jobsis FF. Insufficient supply of reducing equivalents to the respiratory chain in cerebral cortex during severe insulin-induced hypoglycemia in cats. J Cereb Blood Flow Metab 1986;6:286–291

    PubMed  CAS  Google Scholar 

  32. Wyatt JS, Cope M, Delpy DT, et al. Cerebral oxygenation and hemodynamics during neonatal seizures assessed by continuous near infrared spectrophotometry. Early Hum Dev 1987;15:307

    Google Scholar 

  33. Brazy JE: Near infrared spcctrophotometry. In: Nelson NM, ed. Current Therapy in Neonatal-Perinatal Medicine, en 2. Toronto: BC Decker, 1990:139–144

    Google Scholar 

  34. Lipman B, Serwer G, Brazy JE. Abnormal cerebral hemodynamics in preterm infants with patent ductus arteriosus. Pediatrics 1982;69:778–781

    PubMed  CAS  Google Scholar 

  35. Lou HC, Lassen NA, Friis-Hansen B. Impaired autoregulation of cerebral blood flow in the distressed newborn infant. J Pediatr 1979;94:118–121

    Article  PubMed  CAS  Google Scholar 

  36. Lou HC, Friis-Hansen B. Arterial blood pressure elevations during motor activity and epileptic seizures in the newborn. Acta Paediatr Scand 1979;68:803–810

    Article  PubMed  CAS  Google Scholar 

  37. Wimberly PD, Lou HC, Pederson H, et al. Hypertensive peaks in the pathogenesis of intraventricular hemorrhage in the newborn: abolitin by phenobarbitone sedation. Acta Pediatr Scand 1982;71:537–542

    Article  Google Scholar 

  38. Mela L, Goodwin CW, Miller LD. In vivo control of mitochondrial enzyme concentrations and activity by oxygen. Am J Physiol 1976;231:1811–1816

    PubMed  CAS  Google Scholar 

  39. McCormick PW, Stewart M, Dujovny M, et al. Clinical application of diffuse near infrared transmission spectroscopy to measure cerebral oxygen metabolism. Hospimedica 1990;8:39–47

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. From the Department of Pediatrics, University of Wisconsin, Madison, WI

    Jane E. Brazy MD

Authors
  1. Jane E. Brazy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was supported by Medical Surgical Foundation, Meriter/Madison General Hospital; General Research Support Grant to the University of Wisconsin from the NIH, Division of Research Facilities and Resources; Wisconsin Alumni Research Foundation; and The Graduate School of the University of Wisconsin.

The author gratefully acknowledges Frans Jobsis-VanderVliet for his review of the manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brazy, J.E. Cerebral oxygen monitoring with near infrared spectroscopy: Clinical application to neonates. J Clin Monitor Comput 7, 325–334 (1991). https://doi.org/10.1007/BF01619354

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01619354

Key words

Search

Navigation