Rallis Dimitrios, Christou Helen, Abdulhayoglu Elisa, El-Dib Mohamed
Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA.
Neonatal Intensive Care Unit, University of Ioannina, Faculty of Medicine, Ioannina, Greece.
J Perinatol. 2025 Apr 15. doi: 10.1038/s41372-025-02303-3.
Organ perfusion and regional tissue oxygen saturation (rSO) can be measured non-invasively using near-infrared spectroscopy (NIRS). While cerebral NIRS monitoring in neonates has been widely used, the adoption of renal NIRS is still evolving. This narrative review explores the application of renal NIRS in neonates and proposes an algorithm for integrating renal and cerebral NIRS in the neonatal intensive care unit. Decreased renal regional oxygenation (RrSO) suggests decreased renal O delivery/perfusion or increased O consumption, warranting evaluation for acute kidney injury, anemia, hemodynamically significant patent ductus arteriosus, or hypotension. Increased RrSO indicates increased renal O delivery/perfusion or decreased O consumption, necessitating assessment for hyperoxia or established kidney injury. Combining cerebral and renal NIRS provides a comprehensive evaluation, allowing for the detection of early clinical changes. This integrated monitoring approach holds promise for improving neonatal outcomes. However, further large-scale studies are needed to establish normal ranges and guide therapeutic interventions.
使用近红外光谱技术（NIRS）可以无创测量器官灌注和局部组织氧饱和度（rSO）。虽然新生儿脑NIRS监测已被广泛应用，但肾NIRS的应用仍在不断发展。这篇叙述性综述探讨了肾NIRS在新生儿中的应用，并提出了一种在新生儿重症监护病房整合肾和脑NIRS的算法。肾局部氧合（RrSO）降低提示肾氧输送/灌注减少或氧消耗增加，需要评估是否存在急性肾损伤、贫血、血流动力学显著的动脉导管未闭或低血压。RrSO升高表明肾氧输送/灌注增加或氧消耗减少，需要评估是否存在高氧或已存在的肾损伤。结合脑和肾NIRS可提供全面评估，有助于检测早期临床变化。这种综合监测方法有望改善新生儿预后。然而，需要进一步的大规模研究来确定正常范围并指导治疗干预。
