{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T02:29:10Z","timestamp":1793500150901,"version":"4.5.0"},"reference-count":22,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Preterm infants are at high risk of developing brain injury, and near-infrared spectroscopy (NIRS) offers the ability to measure cerebral oxygenation. The impact of using a standardized treatment guideline combined with a single NIRS device manufacturer (Nonin Medical Inc) and neonatal sensor on cerebral oxygenation has not been previously examined.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate whether cerebral oximetry with a dedicated treatment guideline improves cerebral oxygenation stability.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a single-blinded, 2-arm randomized clinical trial conducted from October 2021 to July 2024 at 5 tertiary neonatal intensive care units across Australia, New Zealand, and the US. Infants born at less than 29 weeks\u2019 gestation and aged younger than 6 hours underwent 1:1 random allocation stratified by gestational age (&amp;lt;26 weeks and \u226526 weeks) and study site.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n The intervention group received cerebral oximetry and dedicated guideline-based treatment when cerebral oxygenation was outside the range of 65% to 90%. The control group had blinded cerebral oximetry and treatment guided by standard clinical monitoring.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The burden of cerebral hypoxia and hyperoxia during the first 5 days after birth expressed as percentage hours was the primary outcome. Key secondary outcomes were mortality, morbidities before discharge, and NIRS-related skin injury.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 149 screened infants (53 randomized to the intervention and 51 randomized to standard care), 100 infants were included in the final analysis (median [IQR] gestational age, 27 [25-28] weeks; 48 male [48.0%]). The median (IQR) birth weight was 883 (709-1079) g. The intervention group (50 infants) had a significantly lower median (IQR) burden of hypoxia and hyperoxia of 5.7% hours (2.8% hours to 15.0% hours) compared with 39.6% hours (6.5% hours to 82.3% hours) in the standard care group (50 infants), with an adjusted reduction of 42.8% hours (95% CI, 35.6% hours to 53.3% hours;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Mortality, morbidities before discharge, and safety outcomes were comparable between groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, treatment guided by cerebral oximetry with a single device manufacturer and a neonatal sensor significantly improved the stability of cerebral oxygenation in extremely preterm infants. Larger multicenter trials are warranted to determine if this finding leads to improved survival without brain injury.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n Australian New Zealand Clinical Trials Registry registration number\n ACTRN12621000778886<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.57620","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T16:30:32Z","timestamp":1770309032000},"page":"e2557620","source":"Crossref","is-referenced-by-count":3,"title":["Cerebral Oximetry\u2013Guided Treatment and Cerebral Oxygenation in Extremely Preterm Infants"],"prefix":"10.1001","volume":"9","author":[{"given":"Pranav R.","family":"Jani","sequence":"first","affiliation":[{"name":"Department of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, 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