Noninvasive Neuromonitoring Modalities in Children Part I: Pupillometry, Near-Infrared Spectroscopy, and Transcranial Doppler Ultrasonography

Neurocrit Care. 2024 Feb;40(1):130-146. doi: 10.1007/s12028-023-01730-4. Epub 2023 May 9.

Abstract

Background: Noninvasive neuromonitoring in critically ill children includes multiple modalities that all intend to improve our understanding of acute and ongoing brain injury.

Methods: In this article, we review basic methods and devices, applications in clinical care and research, and explore potential future directions for three noninvasive neuromonitoring modalities in the pediatric intensive care unit: automated pupillometry, near-infrared spectroscopy, and transcranial Doppler ultrasonography.

Results: All three technologies are noninvasive, portable, and easily repeatable to allow for serial measurements and trending of data over time. However, a paucity of high-quality data supporting the clinical utility of any of these technologies in critically ill children is currently a major limitation to their widespread application in the pediatric intensive care unit.

Conclusions: Future prospective multicenter work addressing major knowledge gaps is necessary to advance the field of pediatric noninvasive neuromonitoring.

Keywords: Near-infrared spectroscopy; Neuromonitoring; Pediatric neurocritical care; Pupillometry; Transcranial Doppler ultrasonography.

Publication types

  • Review

MeSH terms

  • Brain Injuries*
  • Child
  • Critical Illness
  • Humans
  • Intensive Care Units, Pediatric
  • Multicenter Studies as Topic
  • Spectroscopy, Near-Infrared
  • Ultrasonography, Doppler, Transcranial* / methods