CEREBRAL OXIMETRY USE FOR CARDIAC SURGERY
AbstractBackground: Studies have shown maintaining good cerebral perfusion during Cardiac Surgeries is very important in terms of patient outcomes and reducing the hospital stay, which may have its financial and clinical implications. The aim of this review study was to determine the effectiveness of Cerebral Oximetry (Transcranial Near-Infrared Spectroscopy-NIRS to monitor cerebral oxygenation) for Cardiac Surgery and to propose a possible concluding remark about its potential applications, overall clinical value and whether to keep using it or not. Methods: Medical database and archives including Pubmed, Embase, index medicus, index copernicus and Medline were searched. Different papers were looked upon and each had an argument, scientific evidence and background. Fifteen research papers were selected and brought under review after carefully consideration. Results: The papers were carefully reviewed and findings were given in favour of not using NIRS technique for Cerebral Oximetry in Cardiac Surgery. Conclusion: This can rightly be concluded from this study that NIRS Cerebral Oximetry does not carry the clinical significance and relevance which was previously thought. The subject under observation needs further studies and research to evaluate the effectiveness of the Cerebral Oximetry Use for Cardiac Surgery.Keywords: NIRS; cerebral oximetry; cerebral perfusion
Scheeren TW, Schober P, Schwarte LA. Monitoring tissue oxygenation by near infrared spectroscopy (NIRS): background and current applications. J Clin Monit Comput 2012;26(4):279–87.
Murkin JM. Is it better to shine a light, or rather to curse darkness? Cerebral near-infrared spectroscopy and cardiac surgery. Eur J Cardiothorac Surg 2013;43(6):1081–3.
Edmonds HL, Ganzer BL, Austin EH 3rd. Cerebral Oximetry for Cardiac and Vascular Surgery. Semin Cardiothorac Vasc Aneth 2004;8(2):147–66.
Tan ST. Cerebral oximetry in cardiac surgery. Hong Kong Med J 2008;14(3):220–5.
Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Semin Cardiothorac Vasc Anest 2007:11(4):274–81.
Fischer GW. Recent advances in application of cerebral oximetry in adult cardiovascular surgery. Semin Cardiothorac Vasc Anesth 2008;12(1):60–9.
Friedell ML, Clark JM, Graham DA, Isley MR, Zhang XF. Cerebral oximetry does not correlate with electroencephalography and somatosensory evoked potentials in determining the need for shunting during carotid endarterectomy. J Vasc Surg 2008;48(3):601–6.
Casati A, Spreaflico E, Putzu M, Famelli G. New technology for noninvasive brain monitoring: continuous cerebral oximetry. Minerva Anestesiol 2006;72(7-8):605–25.
Taillefer Mc, Denault AY. Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy. Can J Anesth 2005;52(1):79–87.
Vets P, ten Broecke P, Adriaensen H, Van Schil P, De Hert S. Cerebral oximetry in patients undergoing carotid endarterectomy: preliminary results. Acta Anaesthesiol Belg 2004;55(3):215–20.
Baikoussis NG, Karanikolas M, Siminelakis S, Matsagas M, Papadopoulos G. Baseline cerebral oximetry values in cardiac and vascular surgery patients: A prospective observational study. J Cardiothorac Surg 2010;5:41.
Giustiniano E, Alfano A, Battisini GM, gavazzeni V, Spoto MR, Cancellieri F. Cerebral oximetry during carotid clamping: is blood pressure raising necessary? J Cardiovasc Med (Hagerstown) 2010;11(7):522–8.
Walsh D, Bennett M, Bennett S. Cost analysis of patients undergoing cardiac surgery managed with or without cerebral oximetry (INVOS). BMC Proc 2012;6(Suppl 4):O16.
Society of Thoracic Surgeons. STS Adult Cardiac Surgery Database: Executive Summary: 10 Years. [Internet]. [cited 2016 Dec 20]. http://www.sts.org/sites/default/files/documents/2011%20-%20Adult%20Cardiac%20Surgery%20-1stHarvestExecutiveSummary.pdf
Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I, et al. Monitoring Brain Oxygen Saturation During Coronary Bypass Surgery: A Randomized, Prospective Study. Anesth Analg 2007;104(1):51–58.
Slater JP, Guarino T, Stack J, Vinod K, Bustami RT, Brown JM 3rd, et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg 2009;87(1):36–44.
Goldman S, Sutter F, Ferdinand F, Trace C. Optimizing intraoperative cerebral oxygen delivery using noninvasive cerebral oximetry decreases the incidence of stroke for cardiac surgical patients. Heart Surg Forum 2004;7(5):E376–81.
Palmbergena WA, van Sonderena A, Keyhan-Falsafib AM, Keunen RW, Wolterbeek R. Improved perioperative neurological monitoring of coronary artery bypass graft patients reduces the incidence of postoperative delirium: the Haga Brain Care Strategy. Interact Cardiovasc Thorac Surg 2012;15(4):671–7.