A Review of Monitoring Methods for Cerebral Blood Oxygen Saturation

Zhong, Wentao; Ji, Zhong; Sun, Chengjie

doi:10.3390/healthcare9091104

Cited by 24 publications

(34 citation statements)

References 101 publications

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“…SpO2 can reflect the degree of oxygen saturation of hemoglobin in the patient's blood. Cerebral oxygen saturation is usually measured by jugular venous oxygen saturation (SvjO2), brain tissue oxygen tension (PtiO2), near infrared spectroscopy (NIRS), etc [ 39 ]. The current research has certain limitations.…”

Section: Discussionmentioning

confidence: 99%

In-hospital mortality and SpO2 incritical care patients with cerebral injury: data from the MIMIC‑IV Database

et al. 2022

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Background Evidence regarding the relationship between in-hospital mortality and SpO2 was low oxygen saturations are often thought to be harmful, new research in patients with brain damage has found that high oxygen saturation actually enhances mortality. However, there is currently no clear study to point out the appropriate range for oxygen saturation in patients with craniocerebral diseases. Methods By screening all patients in the MIMIC IV database, 3823 patients with craniocerebral diseases (according to ICD-9 codes and ICD-10) were selected, and non-linear regression was used to analyze the relationship between in-hospital mortality and oxygen saturation. Covariates for all patients included age, weight, diagnosis, duration of ICU stay, duration of oxygen therapy, etc. Results In-hospital mortality in patients with TBI and SAH was kept to a minimum when oxygen saturation was in the 94–96 range. And in all patients, the relationship between oxygen saturation and in-hospital mortality was U-shaped. Subgroup analysis of the relationship between oxygen saturation and mortality in patients with metabolic encephalopathy and other encephalopathy also draws similar conclusions In-hospital mortality and oxygen saturation were all U-shaped in patients with subarachnoid hemorrhage, metabolic and toxic encephalopathy, cerebral infarction, and other encephalopathy, but the nonlinear regression was statistically significant only in patients with cerebral infarction (p for nonlinearity = 0.002). Conclusion Focusing too much on the lower limit of oxygen saturation and ignoring too high oxygen saturation can also lead to increase in-hospital mortality. For patients with TBI and SAH, maintaining oxygen saturation at 94–96% will minimize the in-hospital mortality of patients.

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Section: Discussionmentioning

confidence: 99%

In-hospital mortality and SpO2 incritical care patients with cerebral injury: data from the MIMIC‑IV Database

et al. 2022

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“…Previous studies utilized the parameters such as the estimated cerebral metabolic rate for oxygen, cerebral extraction ratio of oxygen, and CBFe as the markers of cerebral metabolism. [ 12 ] In our present study, we look forward to using an easily derived marker of cerebral metabolism, LOI, in addition to the other markers. [ 13 14 ] The average values of LOI are <0.03, and patients with low oxygen extraction have an LOI >0.08, secondary to the failure of aerobic metabolism in the brain and the resultant increased production of lactic acid.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of markers of cerebral oxygenation and metabolism in patients undergoing clipping of cerebral aneurysm under total intravenous anesthesia versus inhalational anesthesia: A prospective randomized trial (COM-IVIN trial)

Arumadi,

Hrishi,

Prathapadas

et al. 2023

Brain Circulation

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INTRODUCTION: Anesthetic goals in patients undergoing clipping of cerebral aneurysm include maintenance of cerebral blood flow, oxygenation, and metabolism to avoid cerebral ischemia and maintenance of hemodynamic stability. We intend to study the influence of anesthetic agents on the outcome of aneurysmal subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This is a prospective, randomized, parallel, single-center pilot trial approved by the Institutional Ethics Committee and is prospectively registered with the Clinical Trial Registry of India. Patients with aneurysmal SAH (aSAH) admitted to our institution for surgical clipping, fulfilling the trial inclusion criteria, will be randomized in a 1:1 allocation ratio utilizing a computerized random allocation sequence to receive either total intravenous anesthesia (n = 25) or inhalational anesthesia (n = 25). Our primary objective is to study the effects of these anesthetic techniques on cerebral oxygenation and metabolism in patients with aSAH. Our secondary objective is to evaluate the impact of these anesthetic techniques on the incidence of delayed cerebral ischemia and long-term patient outcomes in patients with aSAH. The Modified Rankin Score and Glasgow Outcome Scale (GOS) at discharge and 3 months following hospital discharge will be evaluated. An observer blinded to the study intervention will assess the outcome measures. DISCUSSION: This study will provide more insight as to which is the ideal anesthetic agent that offers a better neurophysiological profile regarding intraoperative cerebral oxygenation and metabolism, thereby contributing to better postoperative outcomes in aSAH patients.

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“…There is wide intra- and interindividual baseline variability in rSO 2 . The “normal” range lies between 60% and 75%, with a coefficient of variation for absolute baseline values of approximately 10% ( 25 , 26 ). It has been reported that rSO 2 <50% or a 20% reduction from the individual baseline is generally considered indicative of the need for intervention ( 19 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative application of regional cerebral oxygen saturation monitoring for geriatric patients in China: a survey

Zhang,

Shen,

Wang

et al. 2023

Front. Med.

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BackgroundRegional cerebral oxygen saturation (rSO2) monitoring is a real-time and non-invasive technique for estimating the balance of regional cerebral oxygen supply and consumption. Despite the growing popularity of this monitoring technique, data regarding outcome benefits remain sparse and contradictory. This study was conducted to explore the popularity and understanding of cerebral oxygen saturation monitoring during anesthesia in geriatric patients.MethodsAn online self-report questionnaire was distributed in March 2021 to various hospitals in China for dissemination to anesthesiologists. Questions surveyed cerebral oximetry equipment and utilization, demographics, and clinical practice of participants.ResultsIn total, 447 anesthesiologists responded. Of these, 301 (67.3%) respondents reported that their hospitals were equipped with cerebral oximetry, which 274 anesthesiologists use during anesthesia. A high percentage of anesthesiologists chose to monitor rSO2 during cardiac surgery (77.4%, n = 212) and neurosurgery (40.5%, n = 111). Most anesthesiologists agreed that a 30% reduction from the rSO2 baseline requires intervention to avoid cerebral ischemia, mainly via elevating arterial pressure and fraction of inspired oxygen (FiO2). Of those without cerebral oximetry, 138 of 146 (94.5%) anesthesiologists were willing to monitor rSO2. In addition, 291 respondents believed that cerebral oxygen monitoring would help prevent postoperative cognitive dysfunction.ConclusionOur survey indicated that the prevalence of cerebral oximetry remains relatively low, while almost all anesthesiologists expressed their willingness to use rSO2 monitoring in geriatric anesthesia. Heterogeneity in clinical practice was identified, indicating relevant knowledge gaps that should encourage further clinical research to optimize treatment.

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A Review of Monitoring Methods for Cerebral Blood Oxygen Saturation

Cited by 24 publications

References 101 publications

In-hospital mortality and SpO2 incritical care patients with cerebral injury: data from the MIMIC‑IV Database

In-hospital mortality and SpO2 incritical care patients with cerebral injury: data from the MIMIC‑IV Database

Evaluation of markers of cerebral oxygenation and metabolism in patients undergoing clipping of cerebral aneurysm under total intravenous anesthesia versus inhalational anesthesia: A prospective randomized trial (COM-IVIN trial)

Intraoperative application of regional cerebral oxygen saturation monitoring for geriatric patients in China: a survey

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