Relationship Between Near-Infrared Spectroscopy and Transabdominal Ultrasonography: Noninvasive Monitoring of Intestinal Function in Neonates

BACKGROUND: Near-infrared spectroscopy (NIRS) has the potential to continuously and noninvasively monitor intestinal function. This technology may be valuable because among neonates, intestinal maturity is highly variable and difficult to assess based solely on clinical signs. The aim of this study was to determine if there is an association between NIRS-based StO(2) measurements and peristaltic activity assessed by transabdominal ultrasonography (US). MATERIAL/METHODS: Nineteen neonates of gestational age >32 weeks were categorized according to “no/low” versus “normal/hyperactive” motility levels, based on blinded US scan results. StO(2) was recorded every 2 s for 24 h, following the ultrasound recording. Differences between the resulting estimates of average StO(2) (bias of fits) and goodness-of-fit (residuals) were evaluated. RESULTS: Newborns with normal/hyperactive motility had higher mean StO(2) than newborns with no/low motility (72.3±4.4 vs. 65.5±7.9, p<0.05, F=5.65). Residual errors were not significantly different between the 2 groups (p=0.213, F=0.213). A multivariate linear regression model using the means, residuals, and pairwise products of both, demonstrated more significant separation (0.47±0.26 vs. −0.24±0.33, p<0.01, F=27.4). A non-linear variant of the multivariate linear regression model demonstrated greatest separation (0.68±0.24 vs. −0.49±0.53, p<0.01, F=41.9). CONCLUSIONS: This is the first study to demonstrate an association between NIRS-based StO(2) measurements and peristaltic activity visualized by ultrasound imaging. NIRS may offer a continuous, noninvasive method to assess motility. This may have significant implications in premature infants at risk for feeding intolerance or necrotizing enterocolitis.