Evidence map›Paper›PMID 41642624›Full record

Trial reportJAMA network open2026

Cerebral Oximetry-Guided Treatment and Cerebral Oxygenation in Extremely Preterm Infants: A Randomized Clinical Trial.

Pranav R Jani, Traci-Anne Goyen, Kiran Kumar Balegar, Rajesh Maheshwari, Maria Saito-Benz, Tim Schindler, James Moore, Manelle Merhi, Melinda Cruz, Yang Song and 20 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Pranav R JaniDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Traci-Anne GoyenDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Kiran Kumar BalegarDepartment of Neonatology, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, Australia.
Rajesh MaheshwariDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Maria Saito-BenzNeonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand.
Tim SchindlerDepartment of Newborn Care, The Royal Hospital for Women, Sydney, New South Wales, Australia.
James MooreConnecticut Children's, Division of Neonatal-Perinatal Medicine, Connecticut Children's Medical Center, Hartford.
Manelle MerhiKennards Hire Group, Sydney, Australia.
Melinda CruzNational Health and Medical Research Council Clinical Trial Centre, University of Sydney, Camperdown, New South Wales, Australia.
Yang SongResearch and Education Network, Westmead Hospital, Westmead, New South Wales, Australia.
Hayley McDonaghDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Melissa LuigDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Mark TracyDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Daphne D'CruzDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Aldo PerdomoDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Stephanie MorakeasDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Vishnu DasireddyDepartment of Neonatology, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, Australia.
Mihaela CulcerDepartment of Neonatology, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, Australia.
Vijay ShingdeDepartment of Neonatology, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, Australia.
Karen BenningtonNeonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand.
Joanna MichalowskiDepartment of Newborn Care, The Royal Hospital for Women, Sydney, New South Wales, Australia.
Andreja FucekDepartment of Newborn Care, The Royal Hospital for Women, Sydney, New South Wales, Australia.
Jennifer QuerimConnecticut Children's, Division of Neonatal-Perinatal Medicine, Connecticut Children's Medical Center, Hartford.
Sean StevensConnecticut Children's, Division of Neonatal-Perinatal Medicine, Connecticut Children's Medical Center, Hartford.
James SantanelliConnecticut Children's, Division of Neonatal-Perinatal Medicine, Connecticut Children's Medical Center, Hartford.
James ElhindiFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Brian GlossWestmead Research Hub, Westmead Institute for Medical Research, Sydney, New South Wales, Australia.
Robert HallidayFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Dharmesh ShahDepartment of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia.
Himanshu PopatFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: 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. Objective: To investigate whether cerebral oximetry with a dedicated treatment guideline improves cerebral oxygenation stability. Design, Setting, and Participants: 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' gestation and aged younger than 6 hours underwent 1:1 random allocation stratified by gestational age (<26 weeks and ≥26 weeks) and study site. Intervention: 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. Main Outcomes and Measures: 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. Results: 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; P < .001). Mortality, morbidities before discharge, and safety outcomes were comparable between groups. Conclusions and Relevance: 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. Trial Registration: Australian New Zealand Clinical Trials Registry registration number ACTRN12621000778886.

Indexed as

BrainHypoxia, BrainInfant, Extremely PrematureOximetryAustraliaFemaleGestational AgeHumansHyperoxiaInfant, NewbornIntensive Care Units, NeonatalMaleNew ZealandOxygenSingle-Blind MethodSpectroscopy, Near-InfraredOxygen

Identifiers

PMID41642624
PMCPMC12878427

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.