A new noninvasive technology, called broadband optical spectroscopy (BOS), has promise to reliably detect necrotizing enterocolitis (NEC) in premature infants at earlier stages, before this devastating intestinal disease progresses enough to be visible on x-ray, according to a first-in-human study from Ann & Robert H. Lurie Children’s Hospital of Chicago published in the Journal of Pediatric Surgery.

NEC strikes suddenly and progresses quickly. At early stages, it can be treated with antibiotics, while more advanced disease often requires surgery and carries a high risk of complications and death. So far, there has been no reliable way to detect it early.

“NEC is one of the most feared diagnoses in any neonatal intensive care unit, and the field has been searching for an early detection tool for decades,” said senior author Seth Goldstein, MD, MPhil, pediatric general and thoracic surgeon at Lurie Children’s and Associate Professor of Surgery at Northwestern University Feinberg School of Medicine. “We are excited that our new handheld device reliably distinguishes NEC from healthy tissue within two minutes, and that it can be used at the bedside without subjecting these fragile babies to any pain or radiation. We hope that additional studies confirm our findings that this tool can screen for early stages of NEC.”

The noninvasive BOS device placed gently on the infant’s abdomen measures infrared light reflecting off the intestines and is able to detect color changes that surgeons recognize as indicative of threatened tissue in NEC.

Dr. Goldstein, working with lead author and research fellow Ashley Dodd, MD, and colleagues, partnered with Vadim Backman’s biomedical engineering lab at Northwestern University to develop BOS.

After achieving prior success using BOS for NEC detection in a mouse model, researchers tested the device in 96 premature infants who were younger than 36 weeks of gestation and did not have congenital cardiac conditions or abdominal wall defects.

“Our results show that BOS is a safe and feasible technology that produced detectable signal changes in premature infants with NEC,” said Dr. Goldstein. “These findings suggest that BOS is a promising and potentially groundbreaking modality for screening and early detection of NEC.”

This research was supported by The Gerber Foundation, Catalyst award from the Center of Physical Genomics at Northwestern University and philanthropic support from Rob and Kristin Goldman and the Christina Carinato Charitable Foundation. Fundings: National Institutes of Health Grants (NIH) grants U54CA268084, R01CA228272, and R01CA225002. Support also came from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number T32HD111386. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Ann & Robert H. Lurie Children’s Hospital of Chicago is a nonprofit organization committed to providing access to exceptional care for every child. It is the only independent, research-driven children’s hospital in Illinois and one of less than 35 nationally. This is where the top doctors go to train, practice pediatric medicine, teach, advocate, research and stay up to date on the latest treatments. Exclusively focused on children, all Lurie Children’s resources are devoted to serving their needs. Research at Lurie Children’s is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report.

Journal

Journal of Pediatric Surgery

DOI

10.1016/j.jpedsurg.2026.162978

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Point-of-care testing has been heralded for its capacity to deliver rapid results directly at or near the site of patient care, dramatically reducing the turnaround time that can otherwise delay critical medical decisions. This attribute is incredibly vital in neonatal care, where swift responses can mitigate risks such as infection, metabolic imbalances, or respiratory distress that frequently afflict low-birth-weight and preterm infants. However, the trade-off between speed and analytical precision has long been a concern, with some clinicians skeptical about the reliability of POC tests when compared to the gold-standard CL methods.

The study in question undertook an exhaustive comparison of POC testing devices and conventional laboratory assays, focusing on several key biomarkers routinely measured in the NICU setting. These included glucose levels, blood gases, hemoglobin, electrolytes, and lactate concentrations. Each parameter offers critical insight into the infant’s physiological status, guiding interventions from fluid management to respiratory support. The challenge has been to determine whether the reduced blood volume requirements and expedient results of POC testing might compromise data accuracy, potentially leading to inappropriate treatment decisions.

Notably, the researchers emphasized the unique physiological and technical challenges posed by low-birth-weight infants. These neonates often have limited blood volume, making traditional blood draws for laboratory tests particularly invasive and risky. Additionally, repeated sampling can precipitate iatrogenic anemia, a condition that further complicates their fragile health profile. POC devices, with their microliter-scale sample prerequisites, present an attractive alternative, but only if analytical fidelity is uncompromised.

By enrolling a substantial cohort of inborn infants admitted to the NICU, the team systematically collected paired blood samples analyzed via both POC devices and central laboratory instruments. Advanced statistical techniques—including Bland-Altman plots and Passing-Bablok regression analyses—were employed to assess the agreement and consistency between the two testing modalities. The findings demonstrated a generally strong correlation for multiple analytes, though some variability was noted contingent on the specific biomarker and clinical context.

For instance, glucose measurements provided by POC devices showed remarkable congruence with laboratory results, reinforcing their utility for immediate hypoglycemia detection—a critical metabolic derangement in newborns. Conversely, discrepancies arose in the quantification of certain blood gases and electrolytes, parameters integral to respiratory and acid-base balance assessment. These variances, while statistically significant, were within clinically acceptable margins for most cases, hinting at a nuanced threshold where POC testing remains reliable yet mandates cautious interpretation.

The study also dissected the operational benefits of POC testing, beyond mere accuracy, underscoring the tangible clinical advantages of minimized blood sampling and accelerated result availability. In a setting often constrained by resource limitations and staff workload, the ability to obtain rapid, bedside measurements could streamline care pathways, reduce the duration of critical monitoring, and enhance family-centered decision-making. These systemic efficiencies bear the potential to transform neonatal care paradigms, particularly in under-resourced hospital environments.

Moreover, the research acknowledged technological advances in POC device engineering, including calibration improvements, sensor refinement, and interface design tailored for neonatal use. These developments have propelled the evolution of increasingly sophisticated POC platforms that rival central laboratories in performance, narrowing previous gaps in diagnostic reliability. The integration of such devices into NICU protocols could signify a shift toward hybrid testing models, combining the immediacy of POC with the confirmatory rigor of centralized lab analytics.

However, the authors cautioned that the adoption of POC testing should not be indiscriminate, emphasizing the need for continuous validation, training, and contextual clinical judgment. False positives or negatives stemming from either modality carry profound risks, especially in an environment as delicate as neonatal intensive care. They advocated for institutional frameworks that incorporate quality assurance measures, periodic proficiency testing, and algorithm-based decision support to harmonize test interpretation with patient-specific clinical variables.

Ultimately, this seminal study bridges a critical knowledge gap, offering empirical evidence that endorses the judicious use of POC testing within neonatal units, particularly for low-birth-weight infants. Its insights advocate for a balanced approach that leverages the speed and low invasiveness of bedside testing without dismissing the indispensable role of central laboratory confirmation. This synergy holds promise for optimizing neonatal clinical outcomes, shortening hospital stays, and alleviating the anxiety of families navigating the uncertainties of early life medical crises.

Furthermore, the implications of this research extend beyond neonatal care, as POC testing technologies evolve and proliferate across various medical disciplines. The methodical evaluation framework employed by Parikh and colleagues establishes a blueprint for assessing diagnostic tools in other vulnerable populations, such as critically ill adults or patients in remote settings. As healthcare increasingly embraces personalized, real-time analytics, the convergence of accuracy, accessibility, and timeliness will define the future of diagnostic medicine.

In conclusion, the compelling evidence presented by this study marks a pivotal advancement in neonatal diagnostics. It reconciles the often competing demands of accuracy, speed, and patient safety, revealing a path forward that integrates point-of-care testing as a complementary, rather than replacement, modality to traditional laboratory analyses. For NICUs worldwide, grappling with escalating demands and the imperative for rapid clinical responsiveness, this research provides a critical endorsement of innovative diagnostic strategies designed to safeguard the most fragile patients—our newborns.

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Article References:
Parikh, I., Saroukhani, S., Rysavy, M. et al. Evaluating the accuracy of point of care testing compared to standard laboratory testing among inborn infants in the neonatal intensive care unit. J Perinatol (2025). https://doi.org/10.1038/s41372-025-02543-3

Image Credits: AI Generated
DOI: 19 December 2025
Keywords: Point-of-Care Testing, Neonatal Intensive Care Unit, Low-Birth-Weight Infants, Diagnostic Accuracy, Blood Biomarkers, Glucose Monitoring, Blood Gases, Electrolytes, Lactate, Central Laboratory Testing, Neonatal Diagnostics