Nahinfrarotspektroskopie

Bolkenius, D.; Dumps, C.; Rupprecht, B.

doi:10.1007/s00101-020-00837-z

Cited by 4 publications

(5 citation statements)

References 126 publications

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“…As a continuous and non-invasive technology, NIRS can penetrate the brain at a depth of 3–4 cm below the skin and estimate oxygenation in detected brain tissue [ 12 , 46 , 47 ]. Several trials have demonstrated a close association between perioperative rSO 2 value and postoperative cognitive outcomes in older patients, which may offer a unique opportunity to elucidate the neuropathological mechanisms of POCD [ 13 , 28 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regional cerebral oxygen saturation (rSO 2 ) monitoring, a non-invasive method to monitor cerebral perfusion and ischemia that is measured by near-infrared spectroscopy (NIRS), has played an essential role in guiding or optimizing perioperative management [ 12 ]. Several studies have revealed that a lower level of rSO 2 during surgery is strongly associated with an increased risk of POCD [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of regional cerebral oxygen saturation monitoring on postoperative cognitive dysfunction in older patients: a systematic review and meta-analysis

et al. 2023

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Background: Postoperative cognitive dysfunction (POCD) is common after surgery and anesthesia, particularly in older patients. It has been reported that regional cerebral oxygen saturation (rSO2) monitoring potentially influences the occurrence of POCD. However, its role in the prevention of POCD remains controversial in older patients. Additionally, the quality of evidence on this topic is still relatively poor. Methods: The electronic databases PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched using the indicated keywords from their inception to June 10, 2022. We limited our meta-analysis to randomized controlled trials (RCTs) that assessed the effects of rSO2 monitoring on POCD in older patients. Methodological quality and risk of bias were assessed. The primary outcome was the incidence of POCD during hospitalization. The secondary outcomes were postoperative complications and the length of hospital stay (LOS). Odds ratios (OR) and 95% confidence intervals (CI) were calculated to determine the incidence of POCD and postoperative complications. The standardized mean difference (SMD) instead of the raw mean difference and 95% CI were calculated for LOS. Results: Six RCTs, involving 377 older patients, were included in this meta-analysis. The incidence of POCD ranges from 17 to 89%, with an overall prevalence of 47% in our pooled analysis. Our results demonstrated that rSO2-guided intervention could reduce the incidence of POCD in older patients undergoing non-cardiac surgery (OR, 0.44; 95% CI, 0.25 to 0.79; P = 0.006) rather than cardiac surgery (OR, 0.69; 95% CI, 0.32 to 1.52; P = 0.36). Intraoperative rSO2 monitoring was also associated with a significantly shorter LOS in older patients undergoing non-cardiac surgery (SMD, -0.93; 95% CI, -1.75 to -0.11; P = 0.03). Neither the incidence of postoperative cardiovascular (OR, 1.12; 95% CI, 0.40 to 3.17; P = 0.83) nor surgical (OR, 0.78; 95% CI, 0.35 to 1.75; P = 0.54) complications were affected by the use of rSO2 monitoring. Conclusion: The use of rSO2 monitoring is associated with a lower risk of POCD and a shorter LOS in older patients undergoing non-cardiac surgery. This may have the potential to prevent POCD in high-risk populations. Further large RCTs are still warranted to support these preliminary findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of regional cerebral oxygen saturation monitoring on postoperative cognitive dysfunction in older patients: a systematic review and meta-analysis

et al. 2023

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“…Das intrakranielle Blutvolumen besteht zu 25–30 % aus arteriellen und zu 70–75 % aus venösen Komponenten. Im Gegensatz zur Pulsoxymetrie beurteilt die NIRS hauptsächlich den nichtpulsatilen venösen Anteil des Blutes und erlaubt eine kontinuierliche und nichtinvasive Echtzeitmessung der rS c O 2 innerhalb eines Bereichs des frontalen Kortex [ 2 ].…”

Section: Diskussionunclassified

Verwendung der intraaortalen Ballonpumpe zur Verbesserung der zerebralen Sauerstoffsättigung nach Reanimation bei einem herzchirurgischen Eingriff

Funk,

Kilger,

Vlachea

et al. 2023

Anaesthesiologie

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“…Anaesthesist von Bolkenius et al [3] ebenfalls ausführlich dargestellt, ist die Datenlage dazu, ob der Einsatz der zerebra-len Oxymetrie geeignet ist, perioperative Komplikationen zu reduzieren und das klinische Outcome zu verbessern, nicht eindeutig. Dies verwundet bei näherer Betrachtung aber auch nicht.…”

Section: Zu 3 Wie In Dieser Ausgabe Von Derunclassified

“…. auch bei der Nahinfrarotspektroskopie fraglich (ist), ob in randomisierten, kontrollierten Studien durch ihre Anwendung jemals ein Überlebensvorteil für bestimmte Patientengruppen nachgewiesen werden kann" [3]. Das wird aber -zumindest den mit der Technologie vertrauten Anwendernicht davon abhalten, diese Technologie einzusetzen.…”

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Klinischer Stellenwert der Zerebraloxymetrie mithilfe der NIRS 2.0

Heringlake

Paarmann

2021

Anaesthesist

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Nahinfrarotspektroskopie

Cited by 4 publications

References 126 publications

Effects of regional cerebral oxygen saturation monitoring on postoperative cognitive dysfunction in older patients: a systematic review and meta-analysis

Effects of regional cerebral oxygen saturation monitoring on postoperative cognitive dysfunction in older patients: a systematic review and meta-analysis

Verwendung der intraaortalen Ballonpumpe zur Verbesserung der zerebralen Sauerstoffsättigung nach Reanimation bei einem herzchirurgischen Eingriff

Klinischer Stellenwert der Zerebraloxymetrie mithilfe der NIRS 2.0

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