{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T02:25:19Z","timestamp":1787970319632,"version":"build-2784847793"},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,26]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>\n                      Pediatric traumatic brain injury (TBI) is a major cause of morbidity and mortality. Preventing cerebral hypoxia and hypoperfusion is crucial. Near-infrared spectroscopy (NIRS), which measures regional cerebral oxygen saturation (rSO\n                      <jats:sub>2<\/jats:sub>\n                      ), may provide a noninvasive method of identifying impaired cerebral oxygenation. Whether NIRS correlates with physiological variables or clinical changes following pediatric TBI is unknown, and its relationship with invasive intracranial pressure (ICP), cerebral perfusion pressure (CPP), and brain tissue oxygenation (PbtO\n                      <jats:sub>2<\/jats:sub>\n                      ) is poorly defined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      This retrospective exploratory study used electronic health records from 2016 to 2022 at a quaternary children\u2019s hospital. Patients \u2264 18 years of age with moderate or severe TBI (admission Glasgow Coma Scale [GCS] score \u2264 12) who underwent bilateral frontal NIRS monitoring and intubation for \u2265 48 hours were included. The repeated-measures correlation test, Mann-Whitney U-test, and Kruskal-Wallis test assessed associations and differences between NIRS rSO\n                      <jats:sub>2<\/jats:sub>\n                      and 1) physiological values (respiratory, hemodynamic, systemic temperature), 2) ICP, CPP, and PbtO\n                      <jats:sub>2<\/jats:sub>\n                      at clinically relevant thresholds, 3) EEG-confirmed seizures, 4) intracranial hemorrhage, and 5) outcomes (admission GCS score, 6-month Glasgow Outcome Scale\u2013Extended [GOS-E] score, and length of stay [LOS] in the pediatric intensive care unit [PICU] and hospital). Significance was defined as p &lt; 0.05 and correlation coefficient |r| &gt; 0.10.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Seventy-two patients were included. NIRS rSO\n                      <jats:sub>2<\/jats:sub>\n                      positively correlated with systolic blood pressure (right, r = 0.12, p &lt; 0.001) and PbtO\n                      <jats:sub>2<\/jats:sub>\n                      \u2265 20 mm Hg (left, r = 0.30; right, r = 0.25; p &lt; 0.001), and NIRS rSO\n                      <jats:sub>2<\/jats:sub>\n                      correlated negatively with systemic temperature (left, r = \u22120.14, p &lt; 0.001) but not with ICP \u2265 20 mm Hg, mean arterial pressure, or suboptimal\/ischemic PbtO\n                      <jats:sub>2<\/jats:sub>\n                      levels. While not statistically significant, NIRS rSO\n                      <jats:sub>2<\/jats:sub>\n                      trended higher following seizure and lower with hemorrhage. Bilateral NIRS rSO\n                      <jats:sub>2<\/jats:sub>\n                      positively correlated with initial GCS score (left, r = 0.393, p = 0.001; right, r = 0.30, p = 0.018) and GOS-E score at 6 months (left, r = 0.315, p = 0.0161; right, r = 0.429, p = 0.0011) but not with PICU or hospital LOS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>\n                      NIRS rSO\n                      <jats:sub>2<\/jats:sub>\n                      demonstrated significant correlations with select physiological parameters, including invasive optimal PbtO\n                      <jats:sub>2<\/jats:sub>\n                      levels and acute outcomes (GCS and GOS-E scores), but not with respiratory measures, invasive neuromonitoring during ICP crisis or brain tissue ischemia, seizures, or intracranial hemorrhage. These findings suggest that noninvasive NIRS in its current state cannot reliably predict many physiological or clinical changes important for moderate to severe pediatric TBI or substitute invasive neuromonitoring.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.peds25567","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:01:05Z","timestamp":1782259265000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Correlation of noninvasive near-infrared spectroscopy with outcomes in pediatric traumatic brain injury"],"prefix":"10.3171","author":[{"given":"Ellie D.","family":"Gabriel","sequence":"first","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nankee K.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumaran","family":"Senthil","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Hejazi-Garcia","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayush","family":"Lacoul","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Mazandi","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mix","family":"Wannasarnmetha","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aashim","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"},{"name":"Center for Data Driven Discovery in Biomedicine, Children\u2019s Hospital of Philadelphia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip B.","family":"Storm","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"},{"name":"Center for Data Driven Discovery in Biomedicine, Children\u2019s Hospital of Philadelphia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy M.","family":"Flanders","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"},{"name":"Center for Data Driven Discovery in Biomedicine, Children\u2019s Hospital of Philadelphia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory G.","family":"Heuer","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"},{"name":"Center for Data Driven Discovery in Biomedicine, Children\u2019s Hospital of Philadelphia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin C.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"},{"name":"Center for Data Driven Discovery in Biomedicine, Children\u2019s Hospital of Philadelphia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Kirschen","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Topjian","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conall","family":"Francoeur","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Yuan","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Tae","family":"Kim","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Pediatric Rehabilitation Medicine, Children\u2019s Hospital of Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd J.","family":"Kilbaugh","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy W.","family":"Huh","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Shan","family":"Lang","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia;"},{"name":"Division of Neurosurgery, Department of Neurosurgery, Children\u2019s Hospital of Philadelphia;"},{"name":"Center for Data Driven Discovery in Biomedicine, Children\u2019s Hospital of Philadelphia; 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