ABSTRACT
The clinical presentation of necrotizing enterocolitis (NEC) is varied and nonspecific, making diagnosis a challenge. There are no accepted objective measurements of disease onset, trajectory, or severity. The presence or absence of clinical and radiographic signs, plus need for operative intervention, may allow rough post hoc categorization, but are subjective and not predictive. Advances in diagnosis could conceivably offer a reduction in morbidity and mortality by helping to avoid advanced disease requiring laparotomy or peritoneal drainage. Optical spectroscopy is the measurement of the interaction of light with tissue, both in frequencies in the visible spectrum and those outside the visible, such as near infrared. There is ample pathophysiologic rationale to hypothesize that optical spectroscopy could be employed as a diagnostic modality for NEC, given that the disease onset is accompanied by the buildup of cellular factors and metabolic by-products that interact with light. This effect would correlate to the clinical color changes associated with NEC, namely a dusky-appearing abdomen and the characteristic necrotic appearance of the intestine. In this chapter, the reported literature and ongoing work with respect to near-infrared spectroscopy (NIRS) and broadband optical spectroscopy (BOS) as they relate to NEC are described.
