Miguel Alsina-Casanova, Mathias Lühr-Hansen, Victoria Aldecoa-Bilbao, Ruth Del Rio, Pierre Maton, Kosmas Sarafidis, Pamela Zafra-Rodriguez, Zachary Andrew Vesoulis, Emmanuele Mastretta, Ilia Bresesti, Marta Gomez-Chiari, Mónica Rebollo, Jamil Khamis, Angelos Baltatzidis, Isabel Benavente-Fernandez, Joshua Shimony, Giovanni Morana, Massimo Agosti, Nuria Carreras, Adriana Cuaresma, Ambre Gau, Athanasia Anastasiou, Simón Pedro Lubian-López, Dimitrios Alexopoulos, Paola Sciortino, Francesca Dessimone, Markus Harboe Olsen, Thais Agut, Gorm Greisen
{"title":"脑氧饱和度指导治疗对早产儿脑损伤的影响--由足月时的磁共振成像评估：一项 SafeBoosC-III 辅助研究。","authors":"Miguel Alsina-Casanova, Mathias Lühr-Hansen, Victoria Aldecoa-Bilbao, Ruth Del Rio, Pierre Maton, Kosmas Sarafidis, Pamela Zafra-Rodriguez, Zachary Andrew Vesoulis, Emmanuele Mastretta, Ilia Bresesti, Marta Gomez-Chiari, Mónica Rebollo, Jamil Khamis, Angelos Baltatzidis, Isabel Benavente-Fernandez, Joshua Shimony, Giovanni Morana, Massimo Agosti, Nuria Carreras, Adriana Cuaresma, Ambre Gau, Athanasia Anastasiou, Simón Pedro Lubian-López, Dimitrios Alexopoulos, Paola Sciortino, Francesca Dessimone, Markus Harboe Olsen, Thais Agut, Gorm Greisen","doi":"10.1159/000539175","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The SafeBoosC-III trial investigated the effect of cerebral oximetry-guided treatment in the first 72 h after birth on mortality and severe brain injury diagnosed by cranial ultrasound in extremely preterm infants (EPIs). This ancillary study evaluated the effect of cerebral oximetry on global brain injury as assessed by magnetic resonance imaging (MRI) at term equivalent age (TEA).</p><p><strong>Methods: </strong>MRI scans were obtained between 36 and 44.9 weeks PMA. The Kidokoro score was independently evaluated by two blinded assessors. The intervention effect was assessed using the nonparametric Wilcoxon rank sum test for median difference and 95% Hodges-Lehmann (HL) confidence intervals (CIs). The intraclass correlation coefficient (ICC) was used to assess the agreement between the assessors.</p><p><strong>Results: </strong>A total of 210 patients from 8 centers were included, of whom 121 underwent MRI at TEA (75.6% of alive patients): 57 in the cerebral oximetry group and 64 in the usual care group. There was an excellent correlation between the assessors for the Kidokoro score (ICC agreement: 0.93, 95% CI: 0.91-0.95). The results showed no significant differences between the cerebral oximetry group (median 2, interquartile range [IQR]: 1-4) and the usual care group (median 3, IQR: 1-4; median difference -1 to 0, 95% HLCI: -1 to 0; p value 0.1196).</p><p><strong>Conclusions: </strong>In EPI, the use of cerebral oximetry-guided treatment did not lead to significant alterations in brain injury, as determined by MRI at TEA. The strong correlation between the assessors highlights the potential of the Kidokoro score in multicenter trials.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0000,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Cerebral Oximetry-Guided Treatment on Brain Injury in Preterm Infants as Assessed by Magnetic Resonance Imaging at Term Equivalent Age: An Ancillary SafeBoosC-III Study.\",\"authors\":\"Miguel Alsina-Casanova, Mathias Lühr-Hansen, Victoria Aldecoa-Bilbao, Ruth Del Rio, Pierre Maton, Kosmas Sarafidis, Pamela Zafra-Rodriguez, Zachary Andrew Vesoulis, Emmanuele Mastretta, Ilia Bresesti, Marta Gomez-Chiari, Mónica Rebollo, Jamil Khamis, Angelos Baltatzidis, Isabel Benavente-Fernandez, Joshua Shimony, Giovanni Morana, Massimo Agosti, Nuria Carreras, Adriana Cuaresma, Ambre Gau, Athanasia Anastasiou, Simón Pedro Lubian-López, Dimitrios Alexopoulos, Paola Sciortino, Francesca Dessimone, Markus Harboe Olsen, Thais Agut, Gorm Greisen\",\"doi\":\"10.1159/000539175\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The SafeBoosC-III trial investigated the effect of cerebral oximetry-guided treatment in the first 72 h after birth on mortality and severe brain injury diagnosed by cranial ultrasound in extremely preterm infants (EPIs). This ancillary study evaluated the effect of cerebral oximetry on global brain injury as assessed by magnetic resonance imaging (MRI) at term equivalent age (TEA).</p><p><strong>Methods: </strong>MRI scans were obtained between 36 and 44.9 weeks PMA. The Kidokoro score was independently evaluated by two blinded assessors. The intervention effect was assessed using the nonparametric Wilcoxon rank sum test for median difference and 95% Hodges-Lehmann (HL) confidence intervals (CIs). The intraclass correlation coefficient (ICC) was used to assess the agreement between the assessors.</p><p><strong>Results: </strong>A total of 210 patients from 8 centers were included, of whom 121 underwent MRI at TEA (75.6% of alive patients): 57 in the cerebral oximetry group and 64 in the usual care group. There was an excellent correlation between the assessors for the Kidokoro score (ICC agreement: 0.93, 95% CI: 0.91-0.95). The results showed no significant differences between the cerebral oximetry group (median 2, interquartile range [IQR]: 1-4) and the usual care group (median 3, IQR: 1-4; median difference -1 to 0, 95% HLCI: -1 to 0; p value 0.1196).</p><p><strong>Conclusions: </strong>In EPI, the use of cerebral oximetry-guided treatment did not lead to significant alterations in brain injury, as determined by MRI at TEA. The strong correlation between the assessors highlights the potential of the Kidokoro score in multicenter trials.</p>\",\"PeriodicalId\":94152,\"journal\":{\"name\":\"Neonatology\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neonatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000539175\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neonatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000539175","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Effect of Cerebral Oximetry-Guided Treatment on Brain Injury in Preterm Infants as Assessed by Magnetic Resonance Imaging at Term Equivalent Age: An Ancillary SafeBoosC-III Study.
Introduction: The SafeBoosC-III trial investigated the effect of cerebral oximetry-guided treatment in the first 72 h after birth on mortality and severe brain injury diagnosed by cranial ultrasound in extremely preterm infants (EPIs). This ancillary study evaluated the effect of cerebral oximetry on global brain injury as assessed by magnetic resonance imaging (MRI) at term equivalent age (TEA).
Methods: MRI scans were obtained between 36 and 44.9 weeks PMA. The Kidokoro score was independently evaluated by two blinded assessors. The intervention effect was assessed using the nonparametric Wilcoxon rank sum test for median difference and 95% Hodges-Lehmann (HL) confidence intervals (CIs). The intraclass correlation coefficient (ICC) was used to assess the agreement between the assessors.
Results: A total of 210 patients from 8 centers were included, of whom 121 underwent MRI at TEA (75.6% of alive patients): 57 in the cerebral oximetry group and 64 in the usual care group. There was an excellent correlation between the assessors for the Kidokoro score (ICC agreement: 0.93, 95% CI: 0.91-0.95). The results showed no significant differences between the cerebral oximetry group (median 2, interquartile range [IQR]: 1-4) and the usual care group (median 3, IQR: 1-4; median difference -1 to 0, 95% HLCI: -1 to 0; p value 0.1196).
Conclusions: In EPI, the use of cerebral oximetry-guided treatment did not lead to significant alterations in brain injury, as determined by MRI at TEA. The strong correlation between the assessors highlights the potential of the Kidokoro score in multicenter trials.
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