{
  "abstract": "Objective During perinatal transition, compromised cerebral oxygenation may contribute to neonatal morbidity and mortality. Near-infrared spectroscopy measures cerebral regional tissue oxygen saturations (crSO 2) 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 crSO 2 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 crSO 2 <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 crSO 2 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 crSO 2 with a dedicated treatment guideline in preterm infants.",
  "authors": [
    {
      "affiliations": [
        "Department of Neonatology, Royal Infirmary of Edinburgh, Edinburgh, UK"
      ],
      "name": "Vix Monnelly"
    },
    {
      "affiliations": [
        "Department of Paediatrics and Child Health, Chris Hani Baragwanath Hospital, Johannesburg, South Africa"
      ],
      "name": "Firdose Nakwa"
    },
    {
      "affiliations": [
        "Division of Neonatal-Perinatal Medicine, Saint Louis University, St. Louis, Missouri, USA"
      ],
      "name": "Justin B Josephsen"
    },
    {
      "affiliations": [
        "Neonatology, Royal Alexandra Hospital, Edmonoton, Alberta, Canada"
      ],
      "name": "Georg M Schmölzer"
    },
    {
      "affiliations": [
        "Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Anne Lee Solevåg"
    },
    {
      "affiliations": [
        "Paediatrics, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Yacov Rabi"
    },
    {
      "affiliations": [
        "Pediatrics, UT Southwestern Medical Center at Dallas, Dallas, Texas, USA"
      ],
      "name": "Myra H Wyckoff"
    },
    {
      "affiliations": [
        "Pediatrics-Neonatal, University of Michigan Hospital, Ann Arbor, Michigan, USA"
      ],
      "name": "Gary M Weiner"
    },
    {
      "affiliations": [
        "The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Helen G Liley"
    },
    {
      "affiliations": [],
      "name": "on behalf of the International Liaison Committee on Resuscitation Neonatal Life Support Task Force"
    }
  ],
  "title": "Near-infrared spectroscopy during respiratory support at birth: a systematic review",
  "uid": "9fbab97b-c486-5e0f-bf28-af4307a00b72"
}