Near-Infrared Spectroscopy as a Hemodynamic Monitoring Tool during Neonatal Extracorporeal Life Support: A Case Series.

Near-infrared spectroscopy (NIRS) is a non-invasive clinical tool allowing for real-time, continuous measurement of regional tissue oxygenation (rSO2); though predominantly used for neuromonitoring, it also has the potential for early detection of hemodynamic compromise in the patients on extracorporeal life support (ECLS). The authors present two cases of neonates for whom continuous monitoring of multisite rSO2 with NIRS provided the first indication of a significant compromise in hemodynamic status from catastrophic hemorrhagic complications while on ECLS ahead of conventional ECLS monitoring parameters. Routine NIRS monitoring of neonates on ECLS has utility for ongoing assessment of hemodynamic status and can be used for early detection of complications leading to impaired tissue perfusion.