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A narrative review of the clinical applications of renal NIRS and integration with cerebral NIRS in the NICU

Journal of Perinatology volume 45, pages 1655–1663 (2025)Cite this article

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Abstract

Organ perfusion and regional tissue oxygen saturation (rSO2) 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 (RrSO2) suggests decreased renal O2 delivery/perfusion or increased O2 consumption, warranting evaluation for acute kidney injury, anemia, hemodynamically significant patent ductus arteriosus, or hypotension. Increased RrSO2 indicates increased renal O2 delivery/perfusion or decreased O2 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.

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Fig. 1: Simultaneous measurement of CrSO2 and RrSO2 in a stable neonate.
Fig. 2: Simultaneous measurement of CrSO2 and RrSO2 in a preterm neonate with AKI.
Fig. 3: Simultaneous measurement of CrSO2 and RrSO2 in a neonate with hypotension without AKI.
Fig. 4: Simultaneous measurement of CrSO2 and RrSO2 in a neonate with a hypoxic event affecting both CrSO2 and RrSO2.
Fig. 5: Suggested algorithm for interpreting neonatal cerebral and renal rSO2.

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References

  1. Sood BG, McLaughlin K, Cortez J. Near-infrared spectroscopy: applications in neonates. Semin Fetal Neonatal Med. 2015;20:164–72.

    Article  PubMed  Google Scholar 

  2. Pellicer A, Bravo. MdC. Near-infrared spectroscopy: a methodology-focused review. Semin Fetal Neonatal Med. 2011;16:42–49.

    Article  PubMed  Google Scholar 

  3. Mintzer JP, Moore JE. Regional tissue oxygenation monitoring in the neonatal intensive care unit: evidence for clinical strategies and future directions. Pediatr Res. 2019;86:296–304.

    Article  PubMed  Google Scholar 

  4. Altit G, Bhombal S, Chock VY. End-organ saturations correlate with aortic blood flow estimates by echocardiography in the extremely premature newborn—an observational cohort study. BMC Pediatr. 2021;21:312–20.

  5. Bailey S, Hendricks-Munoz K, Mally P. Cerebral, renal, and splanchnic tissue oxygen saturation values in healthy term newborns. Am J Perinatol. 2014;31:339–44.

    PubMed  Google Scholar 

  6. Bernal NP, Hoffman GM, Ghanayem NS, Arca MJ. Cerebral and somatic near-infrared spectroscopy in normal newborns. J Pediatr Surg. 2010;45:1306–10.

    Article  PubMed  Google Scholar 

  7. Harer MW, Condit PE, Chuck JE, Lasarev MR, Chock VY. Renal oxygenation measured by near-infrared spectroscopy in preterm neonates in the first week. Pediatr Res. 2022;92:1744–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hoffman SB, Magder LS, Viscardi RM. Renal versus cerebral saturation trajectories: the perinatal transition in preterm neonates. Pediatr Res. 2022;92:1437–42.

    Article  CAS  PubMed  Google Scholar 

  9. Marin T, Williams BL. Renal oxygenation measured by near-infrared spectroscopy in neonates. Adv Neonatal Care. 2021;21:256–66.

    Article  PubMed  Google Scholar 

  10. McNeill S, Gatenby JC, McElroy S, Engelhardt B. Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants. J Perinatol. 2011;31:51–57.

    Article  CAS  PubMed  Google Scholar 

  11. Montaldo P, De Leonibus C, Giordano L, De Vivo M, Giliberti P. Cerebral, renal and mesenteric regional oxygen saturation of term infants during transition. J Pediatr Surg. 2015;50:1273–7.

    Article  PubMed  Google Scholar 

  12. Harer MW, Gadek L, Rothwell AC, Richard L, Starr MC, Adegboro CO. Correlation of renal tissue oxygenation to venous, arterial, and capillary blood gas oxygen saturation in preterm neonates. Am J Perinatol. 2023;41:e1228–e1234.

    PubMed  Google Scholar 

  13. Kazmi SH, Verma S, Bailey SM, Mally P, Desai P. Changes in regional tissue oxygen saturation values during the first week of life in stable preterm infants. J Perinat Med. 2024;52:445–51.

    Article  PubMed  Google Scholar 

  14. Kooi EMW, Mintzer JP, Rhee CJ, Ergenekon E, Schwarz CE, Pichler G, et al. Neonatal somatic oxygenation and perfusion assessment using near-infrared spectroscopy. Pediatr Res. 2024;96:1180–94.

    Article  PubMed  Google Scholar 

  15. Jeon GW. Clinical application of near-infrared spectroscopy in neonates. Neonatal Med. 2019;26:121–7.

    Article  Google Scholar 

  16. Pavlek LR, Mueller C, Jebbia MR, Kielt MJ, Fathi O. Near-infrared spectroscopy in extremely preterm infants. Front Pediatr. 2021;8:624113–9.

  17. Agudelo-Pérez S, Troncoso G, Botero-Rosas D, Muñoz C, Rodríguez A, Gómez AV, et al. Renal Regional Oxygen Saturation and Acute Kidney Injury in Neonates with Perinatal Asphyxia. Am J Perinatol. 2025;42:379–86.

  18. Chock VY, Frymoyer A, Yeh CG, Van Meurs KP. Renal saturation and acute kidney injury in neonates with hypoxic ischemic encephalopathy undergoing therapeutic hypothermia. J Pediatr. 2018;200:232–239.e231.

    Article  PubMed  Google Scholar 

  19. Rumpel JA, Spray BJ, Frymoyer A, Rogers S, Cho S-H, Ranabothu S, et al. Renal oximetry for early acute kidney injury detection in neonates with hypoxic ischemic encephalopathy receiving therapeutic hypothermia. Pediatr Nephrol. 2023;38:2839–49.

    Article  PubMed  Google Scholar 

  20. Wu TW, Tamrazi B, Soleymani S, Seri I, Noori S. Hemodynamic changes during rewarming phase of whole-body hypothermia therapy in neonates with hypoxic-ischemic encephalopathy. J Pediatr. 2018;197:68–74.e62.

    Article  PubMed  Google Scholar 

  21. Bonsante F, Ramful D, Binquet C, Samperiz S, Daniel S, Gouyon JB, et al. Low renal oxygen saturation at near-infrared spectroscopy on the first day of life is associated with developing acute kidney injury in very preterm infants. Neonatology. 2019;115:198–204.

    Article  CAS  PubMed  Google Scholar 

  22. Harer MW, Adegboro CO, Richard LJ, McAdams RM. Non-invasive continuous renal tissue oxygenation monitoring to identify preterm neonates at risk for acute kidney injury. Pediatr Nephrol. 2021;36:1617–25.

    Article  PubMed  Google Scholar 

  23. Bhatt M, Petrova A, Mehta R. Does treatment of patent ductus arteriosus with cyclooxygenase inhibitors affect neonatal regional tissue oxygenation? Pediatr Cardiol. 2012;33:1307–14.

    Article  PubMed  Google Scholar 

  24. Petrova A, Bhatt M, Mehta R. Regional tissue oxygenation in preterm born infants in association with echocardiographically significant patent ductus arteriosus. J Perinatol. 2011;31:460–4.

    Article  CAS  PubMed  Google Scholar 

  25. Underwood MA, Milstein JM, Sherman MP. Near-infrared spectroscopy as a screening tool for patent ductus arteriosus in extremely low birth weight infants. Neonatology. 2007;91:134–9.

    Article  PubMed  Google Scholar 

  26. Arman D, Sancak S, Gürsoy T, Topcuoğlu S, Karatekin G, Ovalı F. The association between NIRS and Doppler ultrasonography in preterm infants with patent ductus arteriosus. J Matern-Fetal Neonatal Med. 2019;33:1245–52.

    Article  PubMed  Google Scholar 

  27. Arriaga-Redondo M, Rodríguez-Sánchez de la Blanca A, Zunzunegui JL, Ballesteros-Tejerizo F, Rodríguez-Ogando A, González-Navarro P, et al. Impact of catheterized ductal closure on renal and cerebral oximetry in premature neonates. Eur J Pediatr. 2024;183:2753–61.

    Article  PubMed  Google Scholar 

  28. Chock VY, Rose LA, Mante JV, Punn R. Near-infrared spectroscopy for detection of a significant patent ductus arteriosus. Pediatr Res. 2016;80:675–80.

    Article  PubMed  Google Scholar 

  29. Guzoglu N, Sari FN, Ozdemir R, Oguz SS, Uras N, Altug N, et al. Renal and mesenteric tissue oxygenation in preterm infants treated with oral ibuprofen. J Matern-Fetal Neonatal Med. 2014;27:197–203.

    Article  CAS  PubMed  Google Scholar 

  30. Navikienė J, Liubšys A, Viršilas E, Žvirblis T, Jankauskienė A. Impact of medical treatment of hemodynamically significant patent ductus arteriosus on cerebral and renal tissue oxygenation measured by near-infrared spectroscopy in very low-birth-weight infants. Medicina (Kaunas). 2022;58:475–83.

  31. Navikiene J, Virsilas E, Vankeviciene R, Liubsys A, Jankauskiene A. Brain and renal oxygenation measured by NIRS related to patent ductus arteriosus in preterm infants: a prospective observational study. BMC Pediatr. 2021;21:559–65.

  32. Rose LA, Frymoyer A, Bhombal S, Chock VY. Renal oxygen saturations and acute kidney injury in the preterm infant with patent ductus arteriosus. Am J Perinatol. 2023;41:e2606–e2612.

    PubMed  Google Scholar 

  33. van der Laan ME, Roofthooft MTR, Fries MWA, Berger RMF, Schat TE, van Zoonen AGJF, et al. A hemodynamically significant patent ductus arteriosus does not affect cerebral or renal tissue oxygenation in preterm infants. Neonatology. 2016;110:141–7.

    Article  PubMed  Google Scholar 

  34. Dani C, Pratesi S, Fontanelli G, Barp J, Bertini G. Blood transfusions increase cerebral, splanchnic, and renal oxygenation in anemic preterm infants. Transfusion. 2010;50:1220–6.

    Article  PubMed  Google Scholar 

  35. Mintzer JP, Parvez B, Chelala M, Alpan G, LaGamma EF. Monitoring regional tissue oxygen extraction in neonates <1250 g helps identify transfusion thresholds independent of hematocrit. J Neonatal Perinat Med. 2014;7:89–100.

    Article  CAS  Google Scholar 

  36. Mintzer JP, Parvez B, La Gamma EF. Regional tissue oxygen extraction and severity of anemia in very low birth weight neonates: a pilot NIRS analysis. Am J Perinatol. 2018;35:1411–8.

    Article  PubMed  Google Scholar 

  37. Seidel D, Blaser A, Gebauer C, Pulzer F, Thome U, Knupfer M. Changes in regional tissue oxygenation saturation and desaturations after red blood cell transfusion in preterm infants. J Perinatol. 2013;33:282–7.

    Article  CAS  PubMed  Google Scholar 

  38. Algra SO, Schouten ANJ, van Oeveren W, van der Tweel I, Schoof PH, Jansen NJG, et al. Low-flow antegrade cerebral perfusion attenuates early renal and intestinal injury during neonatal aortic arch reconstruction. J Thorac Cardiovascular Surg. 2012;144:1323–1328.e1322.

    Article  Google Scholar 

  39. Altit G, Bhombal S, Tacy TA, Chock VY. End-organ saturation differences in early neonatal transition for left- versus right-sided congenital heart disease. Neonatology. 2018;114:53–61.

    Article  CAS  PubMed  Google Scholar 

  40. Berens RJ, Stuth EA, Robertson FA, Jaquiss RD, Hoffman GM, Troshynski TJ, et al. Near infrared spectroscopy monitoring during pediatric aortic coarctation repair. Paediatr Anaesth. 2006;16:777–81.

    Article  PubMed  Google Scholar 

  41. Condit PE, Gorski DP, Lasarev MR, Al-Subu AM, Harer MW. Decreased intraoperative renal tissue oxygenation after cardiopulmonary bypass predicts cardiac surgery-associated acute kidney injury in neonates. Children 2024;11:315–21.

  42. Hoffman GM, Ghanayem NS, Scott JP, Tweddell JS, Mitchell ME, Mussatto KA. Postoperative cerebral and somatic near-infrared spectroscopy saturations and outcome in hypoplastic left heart syndrome. Ann Thorac Surg. 2017;103:1527–35.

    Article  PubMed  Google Scholar 

  43. Jung Kim H, Yeon Park J, Man Seo D, Jin Yun T, Park J-J, Gwak M. Acute kidney injury and renal regional oxygen saturation during aortic arch reconstruction in infants. J Cardiothorac Vasc Anesthesia. 2013;27:1153–7.

    Article  Google Scholar 

  44. Sahni PV, Krishnamurthy G, Sahni R. Noninvasive monitoring to demonstrate postoperative differences in regional hemodynamics in newborn infants with d-transposition of the great arteries and hypoplastic left heart syndrome. World J Pediatr Congenit Heart Surg. 2022;14:194–200.

    Article  PubMed  Google Scholar 

  45. Uebing A, Furck AK, Hansen JH, Nufer E, Scheewe J, Dutschke P, et al. Perioperative cerebral and somatic oxygenation in neonates with hypoplastic left heart syndrome or transposition of the great arteries. J Thorac Cardiovasc Surg. 2011;142:523–30.

    Article  PubMed  Google Scholar 

  46. Beck J, Loron G, Masson C, Poli-Merol M-L, Guyot E, Guillot C, et al. Monitoring cerebral and renal oxygenation status during neonatal digestive surgeries using near infrared spectroscopy. Front Pediatr. 2017;5:140–7.

  47. Conforti A, Giliberti P, Landolfo F, Valfre L, Columbo C, Mondi V, et al. Effects of ventilation modalities on near-infrared spectroscopy in surgically corrected CDH infants. J Pediatr Surg. 2016;51:349–53.

    Article  PubMed  Google Scholar 

  48. Conforti A, Giliberti P, Mondi V, Valfré L, Sgro S, Picardo S, et al. Near infrared spectroscopy: experience on esophageal atresia infants. J Pediatr Surg. 2014;49:1064–8.

    Article  PubMed  Google Scholar 

  49. Koch HW, Hansen TG, Kurth D. Perioperative use of cerebral and renal near‐infrared spectroscopy in neonates: a 24‐h observational study. Pediatr Anesthesia. 2015;26:190–8.

    Article  Google Scholar 

  50. Lau PE, Cruz S, Garcia-Prats J, Cuevas M, Rhee C, Cass DL, et al. Use of renal near-infrared spectroscopy measurements in congenital diaphragmatic hernia patients on ECMO. J Pediatr Surg. 2017;52:689–92.

    Article  PubMed  Google Scholar 

  51. Miyake Y, Seo S, Kataoka K, Ochi T, Miyano G, Koga H, et al. Significant neonatal intraoperative cerebral and renal oxygen desaturation identified with near-infrared spectroscopy. Pediatr Surg Int. 2022;38:737–42.

    Article  PubMed  Google Scholar 

  52. Arslan U, Kavrut Ozturk N, Kavakli AS, Dagdelen HO. Comparison of the effects of anaesthesia methods used in caesarean delivery on neonatal cerebral and renal oxygenation: a randomised controlled trial. J Clin Med. 2024;13:873–82.

  53. Harer MW, Rothwell AC, Richard LJ, Adegboro CO, McAdams RM. Renal tissue oxygenation after caffeine administration in preterm neonates. Pediatr Res. 2021;90:1171–6.

    Article  CAS  PubMed  Google Scholar 

  54. Montaldo P, Puzone S, Caredda E, Pugliese U, Inserra E, Cirillo G, et al. Impact of intrauterine growth restriction on cerebral and renal oxygenation and perfusion during the first 3 days after birth. Sci Rep. 2022;12:5067–75.

  55. Richter AE, Schat TE, Van Braeckel KN, Scherjon SA, Bos AF, Kooi EM. The Effect of Maternal Antihypertensive Drugs on the Cerebral, Renal and Splanchnic Tissue Oxygen Extraction of Preterm Neonates. Neonatology. 2016;110:163–71.

    Article  CAS  PubMed  Google Scholar 

  56. Terstappen F, Paauw ND, Alderliesten T, Joles JA, Vijlbrief DC, Lely AT, et al. Elevated renal tissue oxygenation in premature fetal growth restricted neonates: An observational study. Plos One 2018;13:e0204268–78.

  57. van der Laan ME, Schat TE, Olthuis AJ, Boezen HM, Bos AF, Kooi EMW. The association between multisite near-infrared spectroscopy and routine hemodynamic measurements in relation to short-term outcome in preterms with clinical sepsis. Neonatology. 2015;108:297–304.

    Article  PubMed  Google Scholar 

  58. Burns DA, Ciurczak EW. Handbook of near-infrared analysis 2007.

  59. Germon TJ, Evans PD, Barnett NJ, Wall P, Manara AR, Nelson RJ. Cerebral near infrared spectroscopy: emitter-detector separation must be increased. Br J Anaesth. 1999;82:831–7.

    Article  CAS  PubMed  Google Scholar 

  60. Strangman G, Boas DA, Sutton JP. Non-invasive neuroimaging using near-infrared light. Biol Psychiatry. 2002;52:679–93.

    Article  PubMed  Google Scholar 

  61. Almajidy RK, Mankodiya K, Abtahi M, Hofmann UG. A newcomer’s guide to functional near infrared spectroscopy experiments. IEEE Rev Biomed Eng. 2020;13:292–308.

    Article  PubMed  Google Scholar 

  62. Grometto A, Pizzo B, Strozzi MC, Gazzolo F, Gazzolo D. Cerebral NIRS patterns in late preterm and very preterm infants becoming late preterm. J Matern-Fetal Neonatal Med. 2017;32:1124–9.

    Article  PubMed  Google Scholar 

  63. Watzman HM, Kurth CD, Montenegro LM, Rome J, Steven JM, Nicolson SC. Arterial and venous contributions to near-infrared cerebral oximetry. Anesthesiology. 2000;93:947–53.

    Article  CAS  PubMed  Google Scholar 

  64. Garvey AA, Dempsey EM. Applications of near infrared spectroscopy in the neonate. Curr Opin Pediatr. 2018;30:209–15.

    Article  PubMed  Google Scholar 

  65. Vanderhaegen J, Naulaers G, Vanhole C, De Smet D, Van Huffel S, Vanhaesebrouck S, et al. The effect of changes in tPCO2 on the fractional tissue oxygen extraction – as measured by near-infrared spectroscopy – in neonates during the first days of life. Eur J Paediatr Neurol. 2009;13:128–34.

    Article  PubMed  Google Scholar 

  66. Naulaers G, Meyns B, Miserez M, Leunens V, Van Huffel S, Casaer P, et al. Use of tissue oxygenation index and fractional tissue oxygen extraction as non-invasive parameters for cerebral oxygenation. Neonatology. 2007;92:120–6.

    Article  CAS  PubMed  Google Scholar 

  67. Toet MC, Lemmers PMA, van Schelven LJ, van Bel F. Cerebral oxygenation and electrical activity after birth asphyxia: their relation to outcome. Pediatrics. 2006;117:333–9.

    Article  PubMed  Google Scholar 

  68. Balegar V KK, Low GKK, Nanan RKH. Regional tissue oxygenation and conventional indicators of red blood cell transfusion in anaemic preterm infants. EClinicalMedicine. 2022;46:101365–74.

  69. Farag MM, Ghazal HAELR, Ibrahim A, Hammad B. Near-infrared spectroscopy measured cerebral oxygenation in full-term infants during transition: an observational study. Egypt Pediatric Association Gaz. 2022;70:53–62.

  70. Lemmers PMA, Toet M, van Schelven LJ, van Bel F. Cerebral oxygenation and cerebral oxygen extraction in the preterm infant: the impact of respiratory distress syndrome. Exp Brain Res. 2006;173:458–67.

    Article  PubMed  Google Scholar 

  71. Dix LML, van Bel F, Lemmers PMA. Monitoring cerebral oxygenation in neonates: an update. Front Pediatr. 2017;5:46–54.

  72. van Bel F, Lemmers P, Naulaers G. Monitoring neonatal regional cerebral oxygen saturation in clinical practice: value and pitfalls. Neonatology. 2008;94:237–44.

    Article  PubMed  Google Scholar 

  73. Schneider A, Minnich B, Hofstätter E, Weisser C, Hattinger‐Jürgenssen E, Wald M. Comparison of four near‐infrared spectroscopy devices shows that they are only suitable for monitoring cerebral oxygenation trends in preterm infants. Acta Paediatrica. 2014;103:934–8.

    Article  CAS  PubMed  Google Scholar 

  74. Dix LM, van Bel F, Baerts W, Lemmers PM. Comparing near-infrared spectroscopy devices and their sensors for monitoring regional cerebral oxygen saturation in the neonate. Pediatr Res. 2013;74:557–63.

    Article  CAS  PubMed  Google Scholar 

  75. Harer MW, Chock VY. Renal tissue oxygenation monitoring-an opportunity to improve kidney outcomes in the vulnerable neonatal population. Front Pediatr. 2020;8:241.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Greisen G. Cerebral blood flow and oxygenation in infants after birth asphyxia. Clinically useful information? Early Hum Dev. 2014;90:703–5.

    Article  PubMed  Google Scholar 

  77. Szakmar E, Smith J, Yang E, Volpe JJ, Inder T, El-Dib M. Association between cerebral oxygen saturation and brain injury in neonates receiving therapeutic hypothermia for neonatal encephalopathy. J Perinatol. 2021;41:269–77.

    Article  CAS  PubMed  Google Scholar 

  78. Meena J, Kumar J, Kocharlakota JP, Gupta H, Mittal P, Kumar A, et al. Acute kidney injury in neonates: a meta-analysis. Pediatrics. 2024;154:e2023065182.

  79. Condit PE, Chuck JE, Lasarev MR, Chock VY, Harer MW. Renal tissue oxygenation and development of AKI in preterm neonates born < 32 weeks’ gestational age in the first week of age. J Perinatol. 2024;44:434–8.

    Article  CAS  PubMed  Google Scholar 

  80. Iacobelli S, Bonsante F, Ferdinus C, Labenne M, Gouyon JB. Factors affecting postnatal changes in serum creatinine in preterm infants with gestational age <32 weeks. J Perinatol. 2008;29:232–6.

    Article  PubMed  Google Scholar 

  81. Shimada S, Kasai T, Konishi M, Fujiwara T. Effects of patent ductus arteriosus on left ventricular output and organ blood flows in preterm infants with respiratory distress syndrome treated with surfactant. J Pediatr. 1994;125:270–7.

    Article  CAS  PubMed  Google Scholar 

  82. Alderliesten T, Lemmers PM, van Haastert IC, de Vries LS, Bonestroo HJ, Baerts W, et al. Hypotension in preterm neonates: low blood pressure alone does not affect neurodevelopmental outcome. J Pediatr. 2014;164:986–91.

    Article  PubMed  Google Scholar 

  83. Pellicer A, Greisen G, Benders M, Claris O, Dempsey E, Fumagalli M, et al. The SafeBoosC phase II randomised clinical trial: a treatment guideline for targeted near-infrared-derived cerebral tissue oxygenation versus standard treatment in extremely preterm infants. Neonatology. 2013;104:171–8.

    Article  CAS  PubMed  Google Scholar 

  84. Li J, Zhang G, Holtby H, Bissonnette B, Wang G, Redington AN, et al. Carbon dioxide—a complex gas in a complex circulation: Its effects on systemic hemodynamics and oxygen transport, cerebral, and splanchnic circulation in neonates after the Norwood procedure. J Thorac Cardiovascular Surg. 2008;136:1207–14.

    Article  Google Scholar 

  85. Jobes DR, Nicolson SC, Steven JM, Miller M, Jacobs ML, Norwood WI. Carbon dioxide prevents pulmonary overcirculation in hypoplastic left heart syndrome. Ann Thorac Surg. 1992;54:150–1.

    Article  CAS  PubMed  Google Scholar 

  86. Ramamoorthy C, Tabbutt S, Dean Kurth C, Steven JamesM, Montenegro LisaM, Durning S, et al. Effects of inspired hypoxic and hypercapnic gas mixtures on cerebral oxygen saturation in neonates with univentricular heart defects. Anesthesiology. 2002;96:283–8.

    Article  PubMed  Google Scholar 

  87. Hoffman GM, Scott JP, Stuth EA. Effects of arterial carbon dioxide tension on cerebral and somatic regional tissue oxygenation and blood flow in neonates after the norwood procedure with deep hypothermic cardiopulmonary bypass. Front Pediatr. 2022;10:762739–49.

  88. Hanson SJ, Berens RJ, Havens PL, Kim MK, Hoffman GM. Effect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy. Pediatr Emerg Care. 2009;25:150–3.

    Article  PubMed  Google Scholar 

  89. Ortmann LA, Fontenot EE, Seib PM, Eble BK, Brown R, Bhutta AT. Use of near-infrared spectroscopy for estimation of renal oxygenation in children with heart disease. Pediatr Cardiol. 2011;32:748–53.

    Article  PubMed  Google Scholar 

  90. Aviles-Otero N, Kumar R, Khalsa DD, Green G, Carmody JB. Caffeine exposure and acute kidney injury in premature infants with necrotizing enterocolitis and spontaneous intestinal perforation. Pediatr Nephrol. 2018;34:729–36.

    Article  PubMed  Google Scholar 

  91. Harer MW, Askenazi DJ, Boohaker LJ, Carmody JB, Griffin RL, Guillet R, et al. Association between early caffeine citrate administration and risk of acute kidney injury in preterm neonates. JAMA Pediatr. 2018;172–80.

  92. Carmody JB, Harer MW, Denotti AR, Swanson JR, Charlton JR. Caffeine exposure and risk of acute kidney injury in a retrospective cohort of very low birth weight neonates. J Pediatr. 2016;172:63–68.e61.

    Article  CAS  PubMed  Google Scholar 

  93. Petrova A, Mehta R. Near-infrared spectroscopy in the detection of regional tissue oxygenation during hypoxic events in preterm infants undergoing critical care. Pediatr Crit Care Med. 2006;7:449–54.

    Article  PubMed  Google Scholar 

  94. El-Dib M, Soul JS. Monitoring and management of brain hemodynamics and oxygenation. Neonatal Neurology. Handbook of Clinical Neurology2019. p. 295-314.

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Authors and Affiliations

  1. Division of Newborn Medicine, Department of Pediatrics, Brigham and Women’s Hospital, Boston, MA, USA

    Dimitrios Rallis, Helen Christou, Elisa Abdulhayoglu & Mohamed El-Dib

  2. Neonatal Intensive Care Unit, University of Ioannina, Faculty of Medicine, Ioannina, Greece

    Dimitrios Rallis

  3. Harvard Medical School, Boston, MA, USA

    Helen Christou, Elisa Abdulhayoglu & Mohamed El-Dib

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DR designed the study, drafted the initial manuscript, and critically reviewed and revised the manuscript. HC, and EA, critically reviewed and revised the manuscript. MED conceptualized and designed the study, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

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Rallis, D., Christou, H., Abdulhayoglu, E. et al. A narrative review of the clinical applications of renal NIRS and integration with cerebral NIRS in the NICU. J Perinatol 45, 1655–1663 (2025). https://doi.org/10.1038/s41372-025-02303-3

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