Patterns of use of near-infrared spectroscopy in neonatal intensive care units: international usage survey

Abstract

Aim: To assess uptake and applications of near-infrared spectroscopy (NIRS) by neonatal intensive care units (NICUs).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Cerebral haemodynamics and oxygenation; Clinical applications; Near-infrared spectroscopy; Neonatal intensive care; Neonates.