Cerebral oximetry using near-infrared spectroscopy (NIRS) in cardiovascular and thoracic anaesthesia: A review

Abstract

Near-infrared Spectroscopy (NIRS) has a well-established role in cardiovascular and thoracic anaesthesia, and its use is increasing in popularity. Regional cerebral oxygen saturation monitoring may be helpful for patients who are at risk for cerebral ischemia. During cardiac induction, there is a risk of developing complications like arrhythmias, hypotension, cardiac arrest, ST-segment changes, acute low cardiac output, pulmonary hypertension, diastolic dysfunction, valve dysfunction, residual shunts, or residual obstruction of ventricular outflow tracts, brain injuries, etc; where cerebral oxygen saturation is affected. These complications are multifactorial due to the use of heartlung machines as a result of the issues of aorto-pulmonary shunts, pathophysiological changes in the cardiovascular system, hypothermia, circulatory arrest (DHA), prolonged CPB time, specific surgical technique, anaesthesia, and different medications. The non-invasive, compact, continuous measurement technology known as NIRS tracks oxygenation in the brain, muscle, and other organs. In real time, it senses small changes in tissue oxygenation. We hypothesized that NIRS would be a useful technique for detecting increased susceptibility to ischemic neurologic harm. It could be a helpful technique for tracking brain oxygenation when jugular bulb oxygen saturation monitoring is not an option. NIRS is a useful tool for predicting critical events and figuring out how to handle them for a better outcome and faster discharge.