Cerebral near-infrared spectroscopy monitoring for prevention of brain injury in very preterm infants

Hyttel-Sørensen, Simon; Saem, Lina Støy; Greisen, Gorm; Als‐Nielsen, Bodil; Gluud, Christian

doi:10.1002/14651858.cd011506

Cited by 8 publications

(15 citation statements)

References 37 publications

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“…Observational studies have found that cerebral hypoxia during the transition from intrauterine to extrauterine life has been associated with an increased risk of intracranial haemorrhage, ischaemic lesions and later developmental impairment . The benefits of cerebral NIRS monitoring need to be proven in randomised clinical trials, before the method is routinely applied to extremely premature infants . The SafeBoosC II trial was the first randomised clinical trial to investigate the possibility of reducing the burden of cerebral hypoxia and hyperoxia in extremely preterm infants.…”

Section: Discussionmentioning

confidence: 99%

No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life

et al. 2018

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Section: Discussionmentioning

confidence: 99%

No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life

et al. 2018

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“…Commercially available near-infrared spectroscopy (NIRS) devices are currently used in clinical care and in clinical trials as cerebral oximeters 6 7. Interpretation of cerebral oxygenation as a surrogate measure of cerebral blood flow, however, depends on the assumption of stable oxygen consumption.…”

Section: Introductionmentioning

confidence: 99%

Cerebral oxygenation and blood flow in term infants during postnatal transition: BabyLux project

Carli

Andresen

Giovannella

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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ObjectivesA new device that combines, for the first time, two photonic technologies (time-resolved near-infrared spectroscopy and diffuse correlation spectroscopy) was provided and tested within the BabyLux project. Aim was to validate the expected changes in cerebral oxygenation and blood flow.MethodsA pulse oximeter and the BabyLux device were held in place (right hand/wrist and frontoparietal region, respectively) for 10 min after birth in healthy term infants delivered by elective caesarean section. Pulse oximeter saturation (SpO2), cerebral tissue oxygen saturation (StO2) and blood flow index (BFI) were measured over time. Tissue oxygen extraction (TOE) and cerebral metabolic rate of oxygen index (CMRO2I) were calculated.ResultsThirty infants were enrolled in two centres. After validity check of data, 23% of infants were excluded from TOE and CMRO2I calculation due to missing data. As expected, SpO2 (estimate 3.05 %/min; 95% CI 2.78 to 3.31 %/min) and StO2 (estimate 3.95 %/min; 95% CI 3.63 to 4.27 %/min) increased in the first 10 min after birth, whereas BFI (estimate −2.84×10−9 cm2/s/min; 95% CI −2.50×10−9 to −3.24×10−9 cm2/s/min) and TOE (estimate −0.78 %/min; 95% CI −1.12 to –0.45 %/min) decreased. Surprisingly, CMRO2I decreased (estimate −7.94×10−8/min; 95% CI −6.26×10−8 to −9.62×10−8/min).ConclusionsBrain oxygenation and BFI during transition were successfully and simultaneously obtained by the BabyLux device; no adverse effects were recorded, and the BabyLux device did not limit the standard care. The preliminary results from clinical application of the BabyLux device are encouraging in terms of safety and feasibility; they are consistent with previous reports on brain oxygenation during transition, although the interpretation of the decreasing CMRO2I remains open.Trial registration number NCT02815618.

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“…It consists of four learning objectives and 11 questions ( Table 1). SHS and GG [24][25][26][27][28] took the lead in writing the learning material as well as questions for the quiz. MLH also participated in this process.…”

Section: Training Module On Nirsmentioning

confidence: 99%

Pilot test of an online training module on near-infrared spectroscopy monitoring for the randomised clinical trial SafeBoosC-III

Hansen

Rasmussen

Rubin

et al. 2020

Trials

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Background: SafeBoosC-III is an international randomised clinical trial to evaluate the effect of treatment of extremely preterm infants during the first 3 days of life based on cerebral near-infrared spectroscopy (NIRS) monitoring versus treatment and monitoring as usual. To ensure high quality of the trial intervention as well as of patient care, we have developed a multilingual web-based training program to train relevant staff and test their competence. As we enter an under-explored area of e-learning, we have conducted a pilot study on the first of the five modules comprising the web-based training program to test the feasibility of developing such a program for an international trial with limited resources. Methods:The module in this study focuses on the principles and practice of NIRS monitoring. The pedagogical idea was to integrate training and certification. One-hundred doctors and nurses from five Neonatal Intensive Care Units across China, Spain and Denmark were invited to participate in the pilot study. Upon completion of the NIRS module, participants were invited to evaluate their experience by completing an online survey. Data from closedended questions were analysed using descriptive statistics while data from open-ended questions underwent thematic analysis.Results: In total, 81 of 100 invited staff members entered the training module and completed the online survey. The median time and the number of questions to pass the module was 15 minutes and seven questions, respectively. Most staff found the academic level of the learning material and quiz appropriate (85% and 93% of all staff members, respectively), as well as agreeing that the module was relevant to prepare them to 'use the NIRS device' (90%). Thematic analysis revealed issues such as a discrepancy between learning material and quiz questions, lack of clarity, and technical issues. Conclusion:We provide evidence of the feasibility of developing a multilingual web-based training program for an international trial, despite challenges such as low budget, language barriers and possibly differences in the clinical training of staff. Exploring the integration of training and certification for international trials, the positive results of this study motivate further developments.(Continued on next page)

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Cerebral near-infrared spectroscopy monitoring for prevention of brain injury in very preterm infants

Cited by 8 publications

References 37 publications

No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life

No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life

Cerebral oxygenation and blood flow in term infants during postnatal transition: BabyLux project

Pilot test of an online training module on near-infrared spectroscopy monitoring for the randomised clinical trial SafeBoosC-III

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