Neonatal Brain Oxygenation Study

Targeted Cerebral Saturations in Extremely Preterm Infants

Implementing target ranges for regional cerebral saturations in extremely preterm infants in the first week of life may improve neurodevelopmental outcomes at 22-26 months corrected age compared to those without targeted cerebral saturations (Csat) using near-infrared spectroscopy (NIRS). Infants will be randomized to a targeted cerebral saturation monitoring group with visible reading of Csat or to a control group with cerebral saturation monitoring, but with blinded Csat measures. Those in the targeted Csat group will follow a treatment guideline to maintain cerebral oxygenation in the target range. The primary outcome is neurodevelopmental outcome as determined by Bayley III cognitive scale score.

Inclusion Criteria:

• Very preterm infants with gestational age at least 23 weeks but less than 29 completed weeks
• Less than 6 hours of age

Exclusion Criteria:

• Skin integrity insufficient to allow placement of NIRS sensors
• Decision not to provide full intensive care support
• Congenital condition, other than premature birth, that adversely affects life expectancy or neurodevelopment