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 .
Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery
Background : The current study was design ed to determine the relation between  preoperative cerebral oxygen saturation ( Sco2 ) , variables of cardiopulmonary function , mortality , and morbidity in a heterogeneous cohort of cardiac surgery patients . Methods : In this study , 1,178 consecutive patients scheduled for on-pump surgery were prospect ively studied . Preoperative Sco2 , demographics , N-terminal pro-B-type natriuretic peptide , high-sensitive troponin T , clinical outcomes , and 30-day and 1-yr mortality were recorded . Results : Median additive EuroSCORE  was 5 ( range : 0–19 ) . Thirty-day and 1-yr mortality and major morbidity ( at least two major complications and /or a high-dependency unit stay of at least 10 days ) were 3.5 % , 7.7 % , and 13.3 % , respectively . Median minimal preoperative oxygen supplemented Sco2 ( Sco2min-ox ) was 64 % ( range : 15–92 % ) . Sco2min-ox was correlated ( all : P value < 0.0001 ) with N-terminal pro-B-type natriuretic peptide ( & rgr ; : −0.35 ) , high-sensitive troponin T ( & rgr ; : −0.28 ) , hematocrit ( & rgr ; : 0.34 ) , glomerular filtration rate ( & rgr ; : 0.19 ) , EuroSCORE ( & tgr ; : 0.20 ) , and left ventricular ejection fraction class ( & tgr ; : 0.12 ) . Thirty-day nonsurvivors had a lower Sco2min-ox than survivors ( median 58 % [ 95 % CI , 50.7–62 % ] vs. 64 % [ 95 % CI , 64–65 % ] ; P < 0.0001 ) . Receiver-operating curve analysis of Sco2min-ox and 30-day mortality revealed an area-under-the-curve of 0.71 ( 95 % CI , 0.68–0.73 % ; P < 0.0001 ) in the total cohort and an area-under-the-curve of 0.77 ( 95 % CI , 0.69–0.86 % ; P < 0.0001 ) in patients  with a EuroSCORE more than 10 . Logistic regression based on different EuroSCORE categories ( 0–2 ; 3–5 , 6–10 , > 10 ) , Sco2min-ox , and duration of cardiopulmonary bypass showed that a Sco2min-ox equal or less than 50 % is an independent risk factor for 30-day and 1-yr mortality . Conclusions : Preoperative Sco2 levels are reflective of the severity of cardiopulmonary dysfunction , associated with short- and long-term mortality and morbidity , and may add to preoperative risk stratification in patients undergoing cardiac surgery
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 .