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 Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery: A Randomized Controlled Feasibility Trial
Background : Cerebral oxygen desaturation during cardiac surgery has been associated with adverse perioperative outcomes . Before a large multicenter r and omized controlled trial ( RCT ) on the impact of preventing desaturations on perioperative outcomes , the authors undertook a r and omized prospect i ve , parallel-arm , multicenter feasibility RCT to determine whether an intervention algorithm could prevent desaturations . Methods : Eight Canadian sites r and omized 201 patients between April 2012 and October 2013 . The primary outcome was the success rate of reversing cerebral desaturations below 10 % relative to baseline in the intervention group . Anesthesiologists were blinded to the cerebral saturation values in the control group . Intensive care unit personnel were blinded to cerebral saturation values for both groups . Secondary outcomes included the area under the curve of cerebral desaturation load , enrolment rates , and a 30-day follow-up for adverse events . Results : Cerebral desaturations occurred in 71 ( 70 % ) of the 102 intervention group patients and 56 ( 57 % ) of the 99 control group patients ( P = 0.04 ) . Reversal was successful in 69 ( 97 % ) of the intervention group patients . The mean cerebral desaturation load ( SD ) in the operating room was smaller for intervention group patients compared with control group patients ( 104 [ 217 ] % .min vs. 398 [ 869 ] % .min , mean difference , −294 ; 95 % CI , −562 to −26 ; P = 0.03 ) . This was also true in the intensive care unit ( P = 0.02 ) . There were no differences in adverse events between the groups . Conclusions : Study sites were successful in reversal of desaturation , patient recruitment , r and omization , and follow-up in cardiac surgery , supporting the feasibility of conducting a large multicenter RCT
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 .