Background: Neonatal hypoxic ischemic encephalopathy (HIE) remains a significant cause of mortality and morbidity worldwide. Cerebral near infrared spectroscopy (NIRS) can provide cot side continuous information about changes in brain hemodynamics, oxygenation and metabolism in real time. Objective: To perform a systematic review of cerebral NIRS monitoring in term and near-term infants with HIE. Search Methods: A systematic search was performed in Ovid EMBASE and Medline database from inception to November 2019. The search combined three broad categories: measurement (NIRS monitoring), disease condition [hypoxic ischemic encephalopathy (HIE)] and subject category (newborn infants) using a stepwise approach as per PRISMA guidance. Selection Criteria: Only human studies published in English were included. Data Collection and Analysis: Two authors independently selected, assessed the quality, and extracted data from the studies for this review. Results: Forty-seven studies on term and near-term infants following HIE were identified. Most studies measured multi-distance NIRS based cerebral tissue saturation using monitors that are referred to as cerebral oximeters. Thirty-nine studies were published since 2010; eight studies were published before this. Fifteen studies reviewed the neurodevelopmental outcome in relation to NIRS findings. No randomized study was identified. Conclusion: Commercial NIRS cerebral oximeters can provide important information regarding changes in cerebral oxygenation and hemodynamics following HIE and can be particularly helpful when used in combination with other neuromonitoring tools. Optical measurements of brain metabolism using broadband NIRS and cerebral blood flow using diffuse correlation spectroscopy add additional pathophysiological information. Further randomized clinical trials and large observational studies are necessary with proper study design to assess the utility of NIRS in predicting neurodevelopmental outcome and guiding therapeutic interventions.

中文翻译：

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缺氧缺血性脑病足月儿的脑近红外光谱监测-系统评价。

背景：新生儿缺氧缺血性脑病（HIE）仍然是世界范围内死亡率和发病率的重要原因。脑近红外光谱（NIRS）可以为婴儿床提供实时的有关大脑血液动力学，氧合和代谢变化的连续信息。目的：对HIE的足月和近期婴儿进行脑NIRS监测进行系统的回顾。搜索方法：从成立到2019年11月，在Ovid EMBASE和Medline数据库中进行了系统的搜索。搜索包括以下三大类：测量（NIRS监测），疾病状况[缺氧缺血性脑病（HIE）]和主题类别（新生儿）根据PRISMA指南使用逐步方法。入选标准：仅包括以英语发表的人体研究。数据收集与分析：两位作者独立选择，评估了质量并从研究中提取了数据以进行本综述。结果：确定了47例HIE后足月和近期婴儿的研究。大多数研究使用称为脑血氧饱和度计的监护仪来测量基于近距离NIRS的脑组织饱和度。自2010年以来发表了39项研究；在此之前发表了八项研究。十五项研究回顾了与NIRS发现相关的神经发育结局。未确定随机研究。结论：商用NIRS脑血氧饱和度计可以提供有关HIE后脑氧合和血流动力学变化的重要信息，并且在与其他神经监测工具结合使用时特别有用。使用宽带NIRS光学测量脑部新陈代谢，并使用弥散相关光谱法测量脑血流量可增加其他病理生理信息。通过适当的研究设计，有必要进行进一步的随机临床试验和大型观察性研究，以评估NIRS在预测神经发育结果和指导治疗干预中的效用。