Value of near-infrared spectroscopy in evaluating the risk of neonatal necrotizing enterocolitis: A systematic review and meta-analysis

Purpose: Recently, near-infrared spectroscopy (NIRS) has been proposed for diagnosing patients with neonatal necrotizing enterocolitis (NEC). However, a consensus on the credibility of NIRS in evaluating NEC risk has not been reached. This meta-analysis aimed to evaluate the relationship between NEC and splanchnic regional tissue oxygen saturation (SrSO2) and cerebral regional tissue oxygen saturation (CrSO2) detected by NIRS to clarify the clinical value of NIRS in evaluating the risk of NEC. Methods: Studies using NIRS to monitor regional tissue oxygen saturation (rSO(2)) in neonates with NEC published in PubMed, Web of Science, Embase, and the Cochrane Library were searched from their inception to 30 July 2023. Mean difference (MD), pooled sensitivity, and pooled specificity, along with their 95 % confidence intervals (CI), were calculated, and the random-effects model was used for analysis. This study was registered with PROSPERO (no. CRD42022326783). Results: Fourteen studies including 938 neonates (172 NEC, 766 controls) were identified. SrSO2 was significantly decreased in patients with NEC (MD:-12.52, 95 % CI:-15.95,-9.08; P < 0.00001), and this decrease was observed even before the diagnosis of NEC (MD:-13.79, 95 % CI:-17.97,-9.62; P < 0.00001). The pooled sensitivity and specificity of SrSO2 were 0.80 (95 % CI: 0.69, 0.88) and 0.90 (95 % CI: 0.61, 0.98), respectively. However, no significant difference in CrSO2 was found (MD:-4.37, 95 % CI:-10.62, 1.88; P = 0.17). Conclusions: SrSO2, detected by NIRS, could be a valuable non-invasive method for differentiating NEC from non- NEC neonates. It could differentiate prior to NEC diagnosis.