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Peripheral Near-Infrared Spectroscopy: Methodologic Aspects and a Systematic Review in Post-Cardiac Surgical Patients

Published:November 18, 2016DOI:https://doi.org/10.1053/j.jvca.2016.07.035
      LOSS OF HEMODYNAMIC coherence
      • Ince C.
      Hemodynamic coherence and the rationale for monitoring the microcirculation.
      between macrocirculatory oxygen parameters and the peripheral microvasculature frequently is seen in critically ill patients,
      • Mesquida J.
      • Gruartmoner G.
      • Espinal C.
      Skeletal muscle oxygen saturation (StO2) measured by near-infrared spectroscopy in the critically ill patients.
      including postoperative cardiac surgery patients. Hemodynamic stabilization by volume expansion and pharmacologic cardiovascular support may correct systemic hemodynamic variables but not oxygenation and perfusion of the microcirculation.
      • Ince C.
      Hemodynamic coherence and the rationale for monitoring the microcirculation.
      • Boldt J.
      • Ince C.
      The impact of fluid therapy on microcirculation and tissue oxygenation in hypovolemic patients: A review.
      Persistent microcirculatory abnormalities are associated with adverse patient outcomes.
      • Trzeciak S.
      • McCoy J.V.
      • Phillip Dellinger R.
      • et al.
      Early increases in microcirculatory perfusion during protocol-directed resuscitation are associated with reduced multi-organ failure at 24 h in patients with sepsis.
      Consequently, there is interest in minimally invasive methods to assess the microvasculature in addition to established systemic hemodynamic monitoring in patients admitted to intensive care units (ICUs). One such method is peripheral near-infrared spectroscopy (NIRS), which is described in this article, followed by a systematic review of its application in adult patients admitted to the ICU after cardiac surgery.

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