Monitoring cerebral oxygenation of the immature brain: a neuroprotective strategy?

Monitoring of cerebral oxygenation (rScO) with near-infrared spectroscopy (NIRS) is a feasible noninvasive bedside technique in the NICU. This review discusses the possible neuroprotective role of "pattern recognition" of NIRS-derived rScO in preterm neonates with regard to the prevention of severe intraventricular hemorrhage and hypoxia/hyperoxia-related white matter injury. This neuroprotective role of rScO monitoring is discussed as a modality to aid in the early detection of cerebral oxygenation conditions predisposing to these complications. Practical guidelines are provided concerning management of abnormal rScO patterns as well as a brief discussion concerning the need for international consensus and the legal aspects associated with the introduction of a new NICU bedside monitoring strategy.