Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

Near-infrared spectroscopy (NIRS) is used to monitor regional cerebral oxygenation (rScO2) during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed i) to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and ii) to evaluate...

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Main Author: Henning Bay Nielsen
Format: Article
Language:English
Published: Frontiers Media S.A. 2014-03-01
Series:Frontiers in Physiology
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fphys.2014.00093/full
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author Henning Bay Nielsen
author_facet Henning Bay Nielsen
author_sort Henning Bay Nielsen
collection DOAJ
description Near-infrared spectroscopy (NIRS) is used to monitor regional cerebral oxygenation (rScO2) during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed i) to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and ii) to evaluate whether an intraoperative reduction in rScO2 influences postoperative outcome. The PubMed and Embase database were searched from inception until April 30, 2013 and inclusion criteria were intraoperative NIRS determined rScO2 in adult patients undergoing non-cardiac surgery. The type of surgery and number of patients included were recorded. There was included 113 articles and evidence suggests that rScO2 is reduced during thoracic surgery involving single lung ventilation, major abdominal surgery, hip surgery, and laparascopic surgery with the patient placed in anti-Tredelenburg’s position. Shoulder arthroscopy in the beach chair and carotid endarterectomy with clamped internal carotid artery also cause pronounced cerebral desaturation. A >20% reduction in rScO2 coincides with indices of regional and global cerebral ischemia during carotid endarterectomy. Following thoracic surgery, major orthopedic and abdominal surgery the occurrence of postoperative cognitive dysfunction might be related to intraoperative cerebral desaturation. In conclusion, certain non-cardiac surgical procedures is associated with an increased risk for the occurrence of regional cerebral oxygenation. Evidence for an association between cerebral desaturation and postoperative outcome parameters other than cognitive dysfunction needs to be established.
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spelling doaj.art-0571b87b70484cc8bc6c8cbd2ff2fcd62022-12-21T23:54:50ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2014-03-01510.3389/fphys.2014.0009370501Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgeryHenning Bay Nielsen0RigshospitaletNear-infrared spectroscopy (NIRS) is used to monitor regional cerebral oxygenation (rScO2) during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed i) to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and ii) to evaluate whether an intraoperative reduction in rScO2 influences postoperative outcome. The PubMed and Embase database were searched from inception until April 30, 2013 and inclusion criteria were intraoperative NIRS determined rScO2 in adult patients undergoing non-cardiac surgery. The type of surgery and number of patients included were recorded. There was included 113 articles and evidence suggests that rScO2 is reduced during thoracic surgery involving single lung ventilation, major abdominal surgery, hip surgery, and laparascopic surgery with the patient placed in anti-Tredelenburg’s position. Shoulder arthroscopy in the beach chair and carotid endarterectomy with clamped internal carotid artery also cause pronounced cerebral desaturation. A >20% reduction in rScO2 coincides with indices of regional and global cerebral ischemia during carotid endarterectomy. Following thoracic surgery, major orthopedic and abdominal surgery the occurrence of postoperative cognitive dysfunction might be related to intraoperative cerebral desaturation. In conclusion, certain non-cardiac surgical procedures is associated with an increased risk for the occurrence of regional cerebral oxygenation. Evidence for an association between cerebral desaturation and postoperative outcome parameters other than cognitive dysfunction needs to be established.http://journal.frontiersin.org/Journal/10.3389/fphys.2014.00093/fullBrainCerebral CortexMuscletissue oxygenationintraoperative monitoring
spellingShingle Henning Bay Nielsen
Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery
Frontiers in Physiology
Brain
Cerebral Cortex
Muscle
tissue oxygenation
intraoperative monitoring
title Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery
title_full Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery
title_fullStr Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery
title_full_unstemmed Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery
title_short Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery
title_sort systematic review of near infrared spectroscopy determined cerebral oxygenation during non cardiac surgery
topic Brain
Cerebral Cortex
Muscle
tissue oxygenation
intraoperative monitoring
url http://journal.frontiersin.org/Journal/10.3389/fphys.2014.00093/full
work_keys_str_mv AT henningbaynielsen systematicreviewofnearinfraredspectroscopydeterminedcerebraloxygenationduringnoncardiacsurgery