The only eligible r and omised clinical trial did not demonstrate any consistent effects of NIRS plus a guideline on the assessed clinical outcomes .
The trial was , however , only powered to detect difference in cerebral oxygenation , not morbidities or mortality .
BACKGROUND Cerebral injury and long-term neurodevelopmental impairment is common in extremely preterm infants .
Cerebral near-infrared spectroscopy ( NIRS ) enables continuous estimation of cerebral oxygenation .
This diagnostic method coupled with appropriate interventions if NIRS is out of normal range ( that is cerebral oxygenation within the 55 % to 85 % range ) may offer benefits without causing more harms .
Therefore , NIRS coupled with appropriate responses to abnormal findings on NIRS needs assessment in a systematic review of r and omised clinical trials and quasi-r and omised studies .
OBJECTIVES To evaluate the benefits and harms of interventions that attempt to alter cerebral oxygenation guided by cerebral NIRS monitoring in order to prevent cerebral injury , improve neurological outcome , and increase survival in preterm infants born more than 8 weeks preterm .
Cerebral Oxygen Saturation to Guide Oxygen Delivery in Preterm Neonates for the Immediate Transition after Birth: A 2-Center Randomized Controlled Pilot Feasibility Trial.
OBJECTIVE To assess if monitoring of cerebral regional tissue oxygen saturation ( crSO2 ) using near-infrared spectroscopy ( NIRS ) to guide respiratory and supplemental oxygen support reduces burden of cerebral hypoxia and hyperoxia in preterm neonates during resuscitation after birth . STUDY DESIGN Preterm neonates < 34(+0 ) weeks of gestation were included in a prospect i ve r and omized controlled pilot feasibility study at 2 tertiary level neonatal intensive care units . In a NIRS-visible group , crSO2 monitoring in addition to pulse oximetry was used to guide respiratory and supplemental oxygen support during the first 15 minutes after birth . In a NIRS-not-visible group , only pulse oximetry was used . The primary outcomes were burden of cerebral hypoxia ( < 10th percentile ) or hyperoxia ( > 90th percentile ) measured in % minutes crSO2 during the first 15 minutes after birth . Secondary outcomes were all cause of mortality and /or cerebral injury and neurologic outcome at term age . Allocation sequence was 1:1 with block-r and omization of 30 preterm neonates at each site . RESULTS In the NIRS-visible group burden of cerebral hypoxia in % minutes , crSO2 was halved , and the relative reduction was 55.4 % ( 95 % CI 37.6 - 73.2 % ; P = .028 ) . Cerebral hyperoxia was observed in NIRS-visible group in 3 neonates with supplemental oxygen and in NIRS-not-visible group in 2 . Cerebral injury rate and neurologic outcome at term age was similar in both groups . Two neonates died in the NIRS-not-visible group and none in the NIRS-visible group . No severe adverse reactions were observed . CONCLUSIONS Reduction of burden of cerebral hypoxia during immediate transition and resuscitation after birth is feasible by crSO2 monitoring to guide respiratory and supplemental oxygen support . TRIAL REGISTRATION Clinical Trials.gov : NCT02017691
The only eligible r and omised clinical trial did not demonstrate any consistent effects of NIRS plus a guideline on the assessed clinical outcomes .
The trial was , however , only powered to detect difference in cerebral oxygenation , not morbidities or mortality .
BACKGROUND Cerebral injury and long-term neurodevelopmental impairment is common in extremely preterm infants .
Cerebral near-infrared spectroscopy ( NIRS ) enables continuous estimation of cerebral oxygenation .
This diagnostic method coupled with appropriate interventions if NIRS is out of normal range ( that is cerebral oxygenation within the 55 % to 85 % range ) may offer benefits without causing more harms .
Therefore , NIRS coupled with appropriate responses to abnormal findings on NIRS needs assessment in a systematic review of r and omised clinical trials and quasi-r and omised studies .
OBJECTIVES To evaluate the benefits and harms of interventions that attempt to alter cerebral oxygenation guided by cerebral NIRS monitoring in order to prevent cerebral injury , improve neurological outcome , and increase survival in preterm infants born more than 8 weeks preterm .