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 desaturation predicts cognitive decline and longer hospital stay after cardiac surgery.
BACKGROUND Previous studies have reported an 11 % to 75 % incidence of postoperative cognitive decline among cardiac surgery patients . The INVOS Cerebral Oximeter ( Somanetics Corp , Troy , MI ) is a Food and Drug Administration approved device that measures regional cerebral oxygen ( rSo(2 ) ) saturation . The purpose of this study is to examine whether decreased rSo(2 ) predicts cognitive decline and prolonged hospital stay after coronary artery bypass grafting ( CABG ) . METHODS The rSo(2 ) was monitored intraoperatively in a cohort of primary CABG patients . Patients were prospect ively r and omized to a blinded control group or an unblinded intervention group . Cognitive function was assessed preoperatively , postoperatively , and at 3 months using a battery of st and ardized neurocognitive tests . Cognitive decline was defined as a decrease of one st and ard deviation or more in performance on at least one neurocognitive measure . The rSo(2 ) desaturation score was calculated by multiplying rSo(2 ) below 50 % by time ( seconds ) . Multivariate logistic regression models were used to assess cognitive decline and hospital stay . The change in cognitive performance was also assessed using a multivariate linear regression model . RESULTS Patients with rSo(2 ) desaturation score greater than 3,000%-second had a significantly higher risk of early postoperative cognitive decline [ p = 0.024 ] . Patients with rSo(2 ) desaturation score greater than 3,000%-second also had a near threefold increased risk of prolonged hospital stay ( > 6 days ) [ p = 0.007 ] . CONCLUSIONS Intraoperative cerebral oxygen desaturation is significantly associated with an increased risk of cognitive decline and prolonged hospital stay after CABG
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 .