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 .
The SafeBoosC II randomized trial: treatment guided by near-infrared spectroscopy reduces cerebral hypoxia without changing early biomarkers of brain injury
Background : The SafeBoosC phase II multicentre r and omized clinical trial investigated the benefits and harms of monitoring cerebral oxygenation by near-infrared spectroscopy ( NIRS ) combined with an evidence -based treatment guideline vs. no NIRS data and treatment as usual in the control group during the first 72 h of life . The trial demonstrated a significant reduction in the burden of cerebral hypoxia in the experimental group . We now report the blindly assessed and analyzed treatment effects on electroencephalographic ( EEG ) outcomes ( burst rate and spectral edge frequency 95 % ( SEF95 ) ) and blood biomarkers of brain injury ( S100β , brain fatty acid-binding protein , and neuroketal ) . Methods : One hundred and sixty-six extremely preterm infants were r and omized to either experimental or control group .  EEG was recorded at 64 h of age and blood sample s were collected at 6 and 64 h of age . Results : One hundred and thirty-three EEGs were evaluated . The two groups did not differ regarding burst rates ( experimental 7.2 vs. control 7.7 burst/min ) or SEF95 ( experimental 18.1 vs. control 18.0 Hz ) . The two groups did not differ regarding blood S100β , brain fatty acid-binding protein , and neuroketal concentrations at 6 and 64 h ( n = 123 participants ) . Conclusion : Treatment guided by NIRS  reduced the cerebral burden of hypoxia without affecting EEG or the selected blood biomarkers
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 .