Have a personal or library account? Click to login
Cerebral rScO2 Measured by Near-Infrared Spectroscopy (NIRS) During Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy: A Systematic Review Cover

Cerebral rScO2 Measured by Near-Infrared Spectroscopy (NIRS) During Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy: A Systematic Review

Open Access
|Apr 2024

Figures & Tables

Figure 1.

Flowchart of the study.
Flowchart of the study.

Figure 2.

Quality of the selected articles, using STROBE: cohort studies.
Quality of the selected articles, using STROBE: cohort studies.

Characteristics of included studies_

BIBLIOGRAPHIC DATAPopulationType of studyNeurological outcomeNIRS measurementCut-off valueOutcome
Niezen, C et al. 2018Term and near-term newborns n = 39Retrospective cohort
  • SHORT TERM

  • Brain MRI: VanRooij score

  • aEEG: Epileptic activity

  • LONG TERM:

  • Neurodevelopment: BSID-III at 30 months

Left or right frontoparietalrScO2 >90% at 48 and 72 hrs and in rewarmingrScO2 has no predictive value in the initial phase of HT treatment. After 48 hours its predictive value increases. After rewarming, rScO2 is an even better predictor of outcome than aEEG.
Oliveira Pereira C et al. 2021Term newborns n=28Retrospective cohort
  • LONG TERM:

  • Neurodevelopment: GMDS-Vineland at 18–36 months

Left or right FrontalrScO2 >82% at 48 hrs and in rewarmingComparison of rScO2 between the different neurodevelopmental groups revealed statistically significant differences at 48 hours of life between the moderately impaired and severely impaired groups (p = 0.019), and the severely disabled and normal neurodevelopmental groups (p = 0.013).
Szakmar E et al. 2021Term and near-term newborns n = 49Retrospective cohort
  • SHORT TERM

  • Brain MRI: with and without injury

frontoparietalrScO2>84% in rewarmingThe rScO2 value during hypothermia was not statistically significant. The rScO2 during rewarming was higher in infants with brain damage.
Ancora G et al. 2013Term newborns n=16Retrospective cohort
  • LONG TERM:

  • Neurodevelopment: GMDS global quotient <88.7

Bifrontal TOI at 6,12, 24 hrs-TOI (Tissue Oxygenation Index) values at 12 hours were significantly higher in infants with adverse events (n-4) vs. those without adverse outcomes (n-8) (79.7 +/− 9.4% vs. 67.1+/− 7.9 p=0.034).
Goeral K et al. 2017Term and near-term newborns n = 32Retrospective cohort
  • SHORT TERM

  • Brain MRI: Gray matter and basal ganglia injury

frontoparietal-Values of rScO2 and cFTOE were not significantly different between the two groups (normal and abnormal MRI). A trend of decreased rScO2 and increased cFTOE was observed in patients with normal MRI.
Arriaga-Redondo M et al. 2019Term and near-term newborns n = 23Retrospective cohort
  • SHORT TERM:

  • Brain MRI: Rutherford score

  • LONG TERM:

  • Neurodevelopmental BSID-III at 36 months WISC / GMFCS

left FrontalrScO2 >90%rScO2 values >90% and lack of variability in infants with IHD during cooling provide useful information on the severity of neurological status.
Toet M et al. 2006Term newborns n=18Retrospective cohort
  • LONG TERM:

  • Neurodevelopmental GMDS 3, 9, 18, 36 months and 5 years.

Left Parietal FTOE 24 hrsrScO2 >70% at 24 hrsrScO2 values increased to supranormal values after 24 h in infants with an adverse outcome. At 24 hr, FTOE values of infants with an adverse outcome were significantly lower compared to those with a favorable outcome.
Wintermark P et al. 2014Term newborns n=7Retrospective cohort
  • SHORT TERM

  • Brain MRI: Gray matter and basal ganglia injury

Bifrontal-In the group with adverse outcomes, rScO2 values were significantly higher at 24 hr of life.
Lemmers P et al. 2013Term and near-term newborns n = 39Retrospective cohort
  • SHORT TERM:

  • MRI: basal ganglia lesion, thalamus.

  • LONG TERM

  • Neurodevelopmental GMDS <85 at 18 months

Bilateral frontoparietal FTOEI-The mean cFTOE value reflected the rScO2 patterns of both groups and became very low after 24 h of age in the adverse outcome group.
Shellhaas R et al. 2013Term and near-term newborns n = 21Retrospective cohort
  • SHORT TERM:

  • Brain MRI: Low scores no lesion, high lesion more extensive lesion.

  • Neurodevelopmental: Thompson >10 (Before hypothermia and after rewarming).

Biparietal Thigh (systemic)-Absolute values and variability of rScO2 was independent of short-term outcome. Systemic rSO2 variability was the best single predictor of short-term outcome scores.
Peng S et al. 2015Term and near-term newborns n = 18Retrospective cohort
  • SHORT TERM:

  • Brain MRI: With/without injury

  • Autopsy: With/without injury

BifrontalrScO2 >75.5% in first 10 hours of hypothermiaThe rScO2 was higher in asphyxiated neonates who developed subsequent brain injury. This difference was especially prominent during the first 10 hours of hypothermia treatment.
Jain S et al. 2017Term and near-term newborns n = 21Retrospective cohort
  • SHORT TERM:

  • Brain MRI: None/mild, moderate, severe.

  • LONG TERM:

  • Neurodevelopmental: BSID-III 18–24 months

Medial frontalrScO2>80% at 30 hours of lifeThe rScO2 increased more rapidly in infants with greater lesion seen on MRI. On average, rScO2increased by 0.20 % per hour when MRI scores 0 or 1, by 0.48 % per hour scores of 2, and by 0.68 % per hour scores of 3. Higher rScO2 beyond 24 h correlated with higher odds of worse BSID scores.
Mitra S et al. 2020Term newborns n=14Retrospective cohort
  • SHORT TERM:

  • aEEG: Mild vs. moderate/severe

Medial frontal-The relationship between brain metabolism and oxygenation measured during rewarming after TH in a group of infants with HIE strengthened with increasing degree of brain injury.
Burton V et al. 2015Term and near-term newborns n = 19Retrospective cohort
  • LONG TERM:

  • Neurodevelopmental 2 years, Capute Scale, Mullen.

Bifrontal-mean rScO2 in any period (hypothermia, rewarming or normothermia) was not associated with future impairment or Mullen score.
Shellhaas R et al. 2015Term newborns n=18Retrospective cohort
  • LONG TERM:

  • Neurodevelopment at 18 months: BSID III <85

Biparietal-There was no relationship between rScO2 and outcome (p>0.05 at all-time points
DOI: https://doi.org/10.34763/jmotherandchild.20242801.d-24-00010 | Journal eISSN: 2719-535X | Journal ISSN: 2719-6488
Language: English
Page range: 33 - 44
Submitted on: Feb 5, 2024
Accepted on: Mar 6, 2024
Published on: Apr 19, 2024
Published by: Institute of Mother and Child
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2024 Sergio Agudelo-Pérez, Gloria Troncoso, Alejandra Roa, Ana Gabriela Ariza, Georgina Doumat, Natalia M. Reinoso, Daniel Botero-Rosas, published by Institute of Mother and Child
This work is licensed under the Creative Commons Attribution 4.0 License.