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 .
Avoiding hyperoxia in infants ⩽1250 g is associated with improved short- and long-term outcomes
Objective : To determine the rate and severity of short- and long-term morbidity in very low birth weight infants treated before and after the implementation of a change in clinical practice design ed to avoid hyperoxia . Methods : Analysis of a prospect ively collected data base of all infants ⩽1250 g admitted to two Emory University NICU 's from January 2000 to December 2004 . A change in practice was instituted in January 2003 with the objective of avoiding hyperoxia in preterm infants with target O2 saturation ( SpO2 ) at 93 to 85 % ( Period II ) . Before the change in practice , SpO2 high alarms were set at 100 % and low alarms at 92 % ( Period I ) . Statistical analysis included bivariate analyses and multivariate logistic regression comparing outcomes between the two periods . Results : From January 2000 to December 2004 , 502 infants met enrollment criteria and 202 ( 40 % ) were born in period II , after change in SpO2 targets . Birth weight , gestational age and survival were similar between both periods . The rates for any retinopathy of prematurity , supplemental oxygen at 36 weeks post-conceptional age and the use of steroids for chronic lung disease were significantly lower in the infants born in Period II . There was no difference in the rates of necrotizing enterocolitis , intraventricular hemorrhage and periventricular leukomalacia . At 18 months corrected age ( CA ) , the infants treated during Period II had a higher Mental Developmental Index ( MDI ) scores ( 80.2±18.3 vs 89.2±18.5 ; P 0.02 ) and similar Psychomotor Developmental Index ( PDI ) scores ( 83.9±18.6 vs 89.4±17.2 ; P 0.08 ) than those treated during Period I. The proportion of infants with an MDI or a PDI less than 70 was similar between the periods . Conclusions : The change in practice to avoid hyperoxia is associated with a significant decrease in neonatal morbidity and does not have a detrimental effect on developmental outcomes at 18 months CA
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 .