Cerebral Oximetry

Description

Neurological complications and cognitive deficits are significant problems in cardiac surgery because of their frequency, variety and long-term impact. With improved peri-operative care, however, the prevalence of major acute neurologic abnormalities has decreased. Of growing concern are late neurodevelopmental and behavioral problems associated with open heart surgery. The ultimate consequence is either a regional or global imbalance in cerebral oxygen supply/demand. To facilitate early detection of cerebral hypoxia, several neuromonitoring methodologies have been developed for intraoperative use in cardiovascular surgery. One of these techniques uses near-infrared spectroscopy (NIRS).   Cerebral oximetry is a promising new neuromonitoring technique that is easy to use in the operating room. However, the current available technology has not proven itself to be accurate or reliable nor has its use unequivocally resulted in improved outcome. There remains disagreement in the literature as to whether trends (percent deviation from baseline) are more important than absolute values below a certain threshold. This presentation highlights the role of cerebral oximetry in cardiac surgery.