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Table 1 Overview of previous systematic reviews and meta-analyses evaluating the effect of clinical care guided by cerebral NIRS monitoring on neurological outcomes

From: The clinical effects of cerebral near-infrared spectroscopy monitoring (NIRS) versus no monitoring: a protocol for a systematic review with meta-analysis and trial sequential analysis

First author

Title

Study design

Intervention/comparison

Primary (and neurological) outcome(s)

No. of trials

No. of participant

Published/registered protocol

Adverse events

Risk of bias

Conclusion

Serraino et al. [38]

Effects of cerebral near-infrared spectroscopy on the outcome of patients undergoing cardiac surgery

Systematic review and meta-analysis

Cerebral NIRS monitoring compared with no cerebral NIRS monitoring or an alternative goal-directed therapy

Mortality, acute brain injury (stroke or TCI), neurocognitive function, S100B levels

10

1466 (adults)

Yes

No

Yes

Existing evidence shows no effect of the intervention on clinical outcomes.

More RCTs at low risk of bias are needed.

Yu et al. [39]

Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation

Cochrane review

Cerebral NIRS monitoring compared with blinded or no cerebral NIRS monitoring for perioperative monitoring of brain oxygenation in children and adults

Mortality, postop. stroke/adverse neurodev. outcomes, POD/POCD

15

1822 (adults)

Yes

Yes

Yes

The effect of the intervention is uncertain due to low quality of evidence. More RCTs are needed, especially in the paediatric population, since no such trials exist outside the neonatal care.

Hyttel-Sørensen et al. [55]

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

Cochrane review

Cerebral NIRS monitoring compared with blinded or no cerebral monitoring for at least 24 h in very preterm infants

Mortality, neurodev. disability, IVH, cPVL

1

166 (preterm infants)

Yes

Yes

Yes

Based on one trial with a surrogate primary outcome, the systematic review did not reach sufficient power to prove or disprove the interventions effect on clinical outcomes. More RCTs are needed.

  1. cPVL cystic periventricular leukomalacia, IVH intraventricular haemorrhage, NIRS near-infrared spectroscopy, RCTs randomised clinical trials, POCD postoperative cognitive decline, POD postoperative delirium, TCI transient cerebral ischaemia