Abstract
Oedema is a common clinical finding in critically ill neonates and may reflect systemic illness such as congestive heart failure, hepatic cirrhosis, nephrotic syndrome, sepsis, and acute kidney injury. Oedema is characterised by tissue swelling due to water accumulation in the interstitial space. Currently, the gold standard in clinical practice is visual assessment, which is subjective and limited in accuracy. Alternative methods, such as ultrasound and bioimpedance, have been explored; however, they are unsuitable in neonates and do not provide direct water quantification. Near-infrared spectroscopy (NIRS) is a non-invasive optical method that could measure water content through light interaction between near-infrared light and OH particles within the tissue. This study validated NIRS for oedema assessment using an ex vivo porcine skin model, where controlled oedema was induced by phosphate-buffered saline (PBS) injection. Continuous spectroscopic data were collected via optical fibres positioned perpendicularly and parallel to the tissue. Regression models were developed and evaluated using the spectral data, with partial least squares (PLS) regression outperforming ridge regression (RR) and support vector regression (SVR). Notably, spectra acquired in the parallel configuration yielded superior results (R(2) = 0.97, RMSE = 0.15). These findings support the potential of NIRS as a reliable, quantitative tool for neonatal oedema assessment.