Vix Monnelly, Firdose Nakwa, Justin B Josephsen, Georg M Schmölzer, Anne Lee Solevåg, Yacov Rabi, Myra H Wyckoff, Gary M Weiner, Helen G Liley
{"title":"Near-infrared spectroscopy during respiratory support at birth: a systematic review.","authors":"Vix Monnelly, Firdose Nakwa, Justin B Josephsen, Georg M Schmölzer, Anne Lee Solevåg, Yacov Rabi, Myra H Wyckoff, Gary M Weiner, Helen G Liley","doi":"10.1136/archdischild-2025-328577","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>During perinatal transition, compromised cerebral oxygenation may contribute to neonatal morbidity and mortality. Near-infrared spectroscopy measures cerebral regional tissue oxygen saturations (crSO<sub>2</sub>) and may guide delivery room respiratory management. This review evaluated whether crSO<sub>2</sub> monitoring in addition to routine assessment (clinical assessment, pulse oximetry +/- ECG) compared with routine assessment alone improves neonatal outcomes.</p><p><strong>Design: </strong>Systematic review and meta-analysis based on Ovid MEDLINE, Embase, and Cochrane CENTRAL searches (16 February and 5 November 2024).</p><p><strong>Setting: </strong>Delivery room.</p><p><strong>Patients: </strong>Newborn infants of all gestations, born via any mode, receiving continuous positive airway pressure and/or intermittent positive pressure ventilation during stabilisation/resuscitation.</p><p><strong>Intervention: </strong>crSO<sub>2</sub> monitoring with a dedicated treatment guideline in addition to routine assessment compared with routine assessment alone.</p><p><strong>Main outcome measures: </strong>Survival without neurodevelopmental impairment, survival, severe intraventricular haemorrhage and periventricular leukomalacia (infants <34 weeks); and crSO<sub>2</sub> <10th percentile.</p><p><strong>Results: </strong>Among 566 articles, 3 articles reporting outcomes from 2 randomised controlled trials (RCTs) (667 preterm infants) were identified. No data were found for survival without neurodevelopmental impairment. We could not exclude benefit or harm from delivery room monitoring of crSO<sub>2</sub> for survival (relative risk (RR) 1.02, 95% CI 0.99 to 1.05), severe intraventricular haemorrhage (RR 0.76, 95% CI 0.38 to 1.54), periventricular leukomalacia (RR 1.93, 95% CI 0.66 to 5.70) (n=667; two RCTs) and crSO<sub>2</sub> <10th percentile (RR 1.00, 95% CI 0.78 to 1.29) (n=60; one RCT).</p><p><strong>Conclusions: </strong>The limited evidence could not exclude benefit or harm from delivery room monitoring of crSO<sub>2</sub> with a dedicated treatment guideline in preterm infants.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Disease in Childhood - Fetal and Neonatal Edition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/archdischild-2025-328577","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: During perinatal transition, compromised cerebral oxygenation may contribute to neonatal morbidity and mortality. Near-infrared spectroscopy measures cerebral regional tissue oxygen saturations (crSO2) and may guide delivery room respiratory management. This review evaluated whether crSO2 monitoring in addition to routine assessment (clinical assessment, pulse oximetry +/- ECG) compared with routine assessment alone improves neonatal outcomes.
Design: Systematic review and meta-analysis based on Ovid MEDLINE, Embase, and Cochrane CENTRAL searches (16 February and 5 November 2024).
Setting: Delivery room.
Patients: Newborn infants of all gestations, born via any mode, receiving continuous positive airway pressure and/or intermittent positive pressure ventilation during stabilisation/resuscitation.
Intervention: crSO2 monitoring with a dedicated treatment guideline in addition to routine assessment compared with routine assessment alone.
Main outcome measures: Survival without neurodevelopmental impairment, survival, severe intraventricular haemorrhage and periventricular leukomalacia (infants <34 weeks); and crSO2 <10th percentile.
Results: Among 566 articles, 3 articles reporting outcomes from 2 randomised controlled trials (RCTs) (667 preterm infants) were identified. No data were found for survival without neurodevelopmental impairment. We could not exclude benefit or harm from delivery room monitoring of crSO2 for survival (relative risk (RR) 1.02, 95% CI 0.99 to 1.05), severe intraventricular haemorrhage (RR 0.76, 95% CI 0.38 to 1.54), periventricular leukomalacia (RR 1.93, 95% CI 0.66 to 5.70) (n=667; two RCTs) and crSO2 <10th percentile (RR 1.00, 95% CI 0.78 to 1.29) (n=60; one RCT).
Conclusions: The limited evidence could not exclude benefit or harm from delivery room monitoring of crSO2 with a dedicated treatment guideline in preterm infants.
期刊介绍：
Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
