Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia.
Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia.
Acta Paediatr. 2018 Jul;107(7):1198-1204. doi: 10.1111/apa.14271. Epub 2018 Mar 13.
To assess uptake and applications of near-infrared spectroscopy (NIRS) by neonatal intensive care units (NICUs).
A pre-piloted online questionnaire was distributed in May 2015 to 12 perinatal societies in Asia, Europe, Australasia, North America and Middle East for dissemination to NICUs. Questions surveyed demographics, NIRS research/clinical applications, usage frequency, training approaches and target infant populations.
In total, 255 responses from 235 NICUs were obtained. Of these, 85 (36%) owned a NIRS device. Australian and New Zealand NICUs were more likely to own NIRS technology than Asian (OR 1.12, 95% CI: 0.38-3.37) and North American (OR 2.63, 95% CI: 1.07-6.45) NICUs. A total of 69 (71%) used NIRS within clinical or mixed clinical-research settings, however routine reliance for management and prognostication was low (9% and 3%, respectively). Of those without NIRS technology, 96 (64%) had no acquisition intentions. The main limiting factors were controversial evidence on efficacy (59%) and financial considerations (50%). About 51% of respondents received in-house NIRS training and 32% had access to written guidelines.
There is considerable geographical variation in NIRS usage in NICUs that is, on the whole, limited by consumer perception of lack of evidence for its clinical utility. This knowledge gap should be addressed by future research.
评估新生儿重症监护病房（NICU）对近红外光谱（NIRS）的应用情况。
2015 年 5 月，向亚洲、欧洲、澳大拉西亚、北美和中东的 12 个围产期学会预先发放了一份在线问卷，供 NICU 分发。问题调查了人口统计学、NIRS 研究/临床应用、使用频率、培训方法和目标婴儿人群。
共收到来自 235 个 NICU 的 255 份回复。其中，85 个（36%）拥有 NIRS 设备。澳大利亚和新西兰的 NICU 拥有 NIRS 技术的可能性高于亚洲（OR 1.12，95%CI：0.38-3.37）和北美（OR 2.63，95%CI：1.07-6.45）的 NICU。共有 69 个（71%）在临床或混合临床研究环境中使用 NIRS，但常规依赖于管理和预后的情况较低（分别为 9%和 3%）。在没有 NIRS 技术的情况下，96 个（64%）没有获取意向。主要的限制因素是对疗效的证据存在争议（59%）和经济考虑（50%）。约 51%的受访者接受了内部 NIRS 培训，32%的人获得了书面指南。
NICU 中 NIRS 的使用存在相当大的地域差异，总体上受到消费者对其临床应用缺乏证据的看法的限制。未来的研究应该解决这一知识差距。
