Objective: Cerebral near-infrared spectroscopy (NIRS) was evaluated for use in monitoring global
oxygenation in adult patients after cardiac surgery.
Design: Prospective, randomized clinical monitoring study.
Setting: Intensive care unit for cardiac surgery; university hospital.
Participants: The study included 35 patients scheduled for cardiac surgery with insertion of a
pulmonary artery catheter; patients with known cerebral-vascular perfusion disturbances
were excluded.
Interventions: Noninvasive cerebral NIRS oxygen saturation (rSO2) and conventional intensive care monitoring parameters were assessed.
Measurements and Main Results: Simple regression analysis was used to assess the correlation of rSO2 to hemodynamic parameters. There was fair-to-moderate intersubject correlation to
hemoglobin concentration (r = 0.45, p < 0.0001) and mixed venous oxygen saturation (SmvO2) (r = 0.33, p < 0.0001). Sensitivity and specificity of rSO2 to detect substantial (≥1 standard deviation) changes in mixed venous oxygen saturation
were 94% and 81%, respectively.
Conclusions: Cerebral NIRS in adult patients might not be the tool to replace mixed venous oxygen
monitoring. Further work has to be done to assess its potential to reflect intraindividual
trends.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Cardiothoracic and Vascular AnesthesiaAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Near-infrared spectroscopy.Br J Anaesth. 1999; 82: 418-426
- Near-infrared spectroscopy: Theory and applications.J Cardiothorac Vasc Anesth. 1996; 10: 406-418
- Cerebral monitoring by means of oximetry and somatosensory evoked potentials during carotid endarterectomy.J Neurosurg. 1998; 89: 533-538
- Retrograde cerebral perfusion versus selective cerebral perfusion as evaluated by cerebral oxygen saturation during aortic arch reconstruction.Ann Thorac Surg. 1999; 67: 1091-1096
- Bilateral monitoring of cerebral oxygen saturation in aortic arch surgery.Anaesthesiol Intensivmed Notfallmed Schmerzther. 2001; 36: 388-392
- Cerebral oximetry in patients undergoing carotid endarterectomy under regional anesthesia.Stroke. 1996; 27: 49-55
- An evaluation of bilateral monitoring of cerebral oxygen saturation during pediatric cardiac surgery.Anesth Analg. 2005; 101: 1294-1300
- Relation of cerebral tissue oxygenation index to central venous oxygen saturation in children.Intensive Care Med. 2004; 30: 468-471
- Near-infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation.Pediatr Anesth. 2005; 15: 102-109
- Liver tissue oxygenation as measured by near-infrared spectroscopy in the critically ill child in correlation with central venous oxygen saturation.Intensive Care Med. 2002; 28: 184-189
- Absolute quantification methods in tissue near-infrared spectroscopy.Proc SPIE. 1995; 2389: 486-495
- Measurement of cerebral oxygenation state in anaesthetized children using the INVOS 5100 cerebral oximeter.Paediatr Anaesth. 2003; 13: 384-391
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- Cerebral near-infrared spectroscopy in adult heart surgery: Systematic review of its clinical efficacy.Can J Anaesth. 2005; 52: 79-87
- A noninvasive estimation of mixed venous oxygen saturation using near-infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients.Paediatr Anaesth. 2005; 15: 495-503
- Principles, techniques, and limitations of near-infrared spectroscopy.Can J Appl Physiol. 2004; 29: 463-487
- The light still shines, but not that brightly?.Arch Dis Child Fetal Neonatal Ed. 2003; 88: F263-F268
- Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery.Can J Anesth. 2001; 48: 497-501
- Transcutaneously measured near-infrared spectroscopic liver tissue oxygenation does not correlate with hepatic venous oxygenation in children.Can J Anesth. 2002; 49: 824-829
- Noninvasive monitoring of haemoglobin concentration in paediatric surgical patients using near-infrared spectroscopy.Anaesthesia. 2004; 59: 453-458
- Continuous monitoring of hematocrit values during apheresis for allogeneic peripheral blood stem cell collection.J Hematother. 1998; 7: 493-497
Hamamatsu Photonics. Review of new functions—Tissue Hemoglobin Index (THI). NIRO News, December 4, 2001
- Crit Line: Instrument to aid fluid removal during hemodialysis.ANNA J. 1997; 24: 347-348
Article info
Publication history
Published online: December 30, 2006
Footnotes
Supported by a grant from the Theodor and Ida Herzog-Egli Foundation, Zurich, Switzerland (grant numbers 201 and 239).
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
