Cerebral perfusion monitoring in acute care surgery: current and perspective use

ABSTRACT

Introduction: The technology near infrared spectroscopy (NIRS) has been utilized extensively in several clinical settings and one of which is in cerebral oximetry. This review will provide information on the technology, clinical applications and algorithm to follow when desaturation occurs.

Areas covered: The review will cover the technology of near infrared spectroscopy, cerebral oximetry and the utilization of cerebral oximetry in each clinical setting.

Expert commentary: Cerebral oximetry provides a noninvasive measure of cerebral oxygenation, which when persistently declining, can serve as a warning sign of hemodynamic or metabolic compromise intraoperatively or a predictor of postoperative cognitive dysfunction. Although useful, the cerebral oximetry readings must be interpreted in the context of other clinical information. When cerebral desaturation is confirmed, an algorithm should be followed in an attempt to increase oxygen delivery to the brain and/or decrease cerebral metabolic rate of oxygen.

KEYWORDS:

• Near-infrared spectroscopy
• cerebral oxygenation
• monitoring
• acute care surgery

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

The work was supported by grants from Chang Gung Memorial Hospital (CMRPG3D1621).