A Critical Appraisal of the Role of Near Infrared Spectroscopy (NIRS) in the Pediatric Intensive Care Unit (PICU)

While near infrared spectroscopy is an exciting technology, scientific rigor is required in
order to optimize its appropriate use in the clinical arena. This study will explore the
feasibility and clinical applicability of data obtained from the NIRS device. The ability to
noninvasively monitor peripheral perfusion remains an area of intense research. The most
widely used method is pulse oximetry. The international mandate of its use in operating
rooms in the early 1990s after the publication of the Harvard minimum standards for
monitoring speaks to its unquestionable utility. Its pervasive application notwithstanding,
pulse oximetry merely provides a calibrated ratio of arterial and venous hemoglobin
saturation. While this data is valuable, time-tested, and even may hold the promise of
accurately noninvasively trending cardiac output, cellular dysmetabolism -- hallmarks of
vulnerable, yet viable tissue beds -- are beyond the predictive values of currently
available devices.