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 .
Continuous Monitoring of Cerebral Oxygen Saturation in Elderly Patients Undergoing Major Abdominal Surgery Minimizes Brain Exposure to Potential Hypoxia
Elderly patients are more prone than younger patients to develop cerebral desaturation because of the reduced physiologic reserve that accompanies aging . To evaluate whether monitoring cerebral oxygen saturation ( rSO2 ) minimizes intraoperative cerebral desaturation , we prospect ively monitored rSO2 in 122 elderly patients undergoing major abdominal surgery with general anesthesia .  Patients were r and omly allocated to an intervention group ( the monitor was visible and rSO2 was maintained at ≥75 % of preinduction values ; n = 56 ) or a control group ( the monitor was blinded and anesthesia was managed routinely ; n = 66 ) . Cerebral desaturation ( rSO2 reduction < 75 % of baseline ) was observed in 11 patients of the treatment group ( 20 % ) and 15 patients of the control group ( 23 % ) ( P = 0.82 ) . Mean ( 95 % confidence intervals ) values of mean rSO2 were higher ( 66 % [ 64%–68 % ] ) and the area under the curve below 75 % of baseline ( AUCrSO22 < 75 % of baseline ) was lower ( 0.4 min% [ 0.1–0.8 min% ] ) in patients of the treatment group than in patients of the control group ( 61 % [ 59%–63 % ] and 80 min% [ 2–144 min% ] , respectively ; P = 0.002 and P = 0.017 ) . When considering only patients developing intraoperative cerebral desaturation , a lower Mini Mental State Elimination ( MMSE ) score was observed at the seventh postoperative day in the control group ( 26 [ 25–30 ] ) than in the treatment group ( 28 [ 26–30 ] ) ( P = 0.02 ) , with a significant correlation between the AUCrSO2 < 75 % of baseline and postoperative decrease in MMSE score from preoperative values ( r2= 0.25 , P = 0.01 ) . Patients of the control group with intraoperative cerebral desaturation also experienced a longer time to postanesthesia care unit ( PACU ) discharge ( 47 min [ 13–56 min ] ) and longer hospital stay ( 24 days [ 7–53 ] days ) compared with patients of the treatment group ( 25 min [ 15–35 min ] and 10 days [ 7–23 days ] , respectively ; P = 0.01 and P = 0.007 ) . Using rSO2 monitoring to manage anesthesia in elderly patients undergoing major abdominal surgery reduces the potential exposure of the brain to hypoxia ; this might be associated with decreased effects on cognitive function and shorter PACU and hospital stay
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 .