The application of cerebral oxygen saturation monitoring in cardiac and thoracic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Peiyi ¹ ,  WEI Wei ²

1. Graduate Faculty, West China School of Medicine, Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Anesthesia, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

WEI Wei, Email: 111weiwei@sohu.com;weiw@scu.edu.cn

Keywords：

Cerebral oxygen saturation; near infrared spectroscopy; cardiac surgery; thoracic surgery; one-lung ventilation

DOI：

10.7507/1007-4848.201605039

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Regional cerebral oxygen saturation cerebral oxygen saturation(rScO₂) monitoring by using near-infrared spectroscopy(NIRS) is a simple, sensitive, continuous and noninvasive method, which can detect the change in oxygen supply and demand. It has already draw attentions and applications during perioperative in recent years. The technique was firstly used in cardiac surgery, thereafter some studies found thoracic surgery which mostly used one-lung ventilation also was necessary to monitor rScO₂. A series of studies confirmed there were correlations among perioperative adverse events and rScO₂. In this paper, we reviewed the basic principle of rScO₂, summarized the applications of rScO₂ in cardiac and thoracic surgery, discussed the existing problems.

Citation： LI Peiyi, WEI Wei. The application of cerebral oxygen saturation monitoring in cardiac and thoracic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(12): 988-993. doi: 10.7507/1007-4848.201605039 Copy

1.	Jobsis FF. Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science, 1977, 198(4323): 1264-1267.
2.	De Blasi RA, Ferrari M, Natali A, et al. Noninvasive measurement of forearm blood flow and oxygen consumption by near-infrared spectroscopy. J Appl Physiol, 1994, 76(3): 1388-1393.
3.	Tweddell JS, Ghanayem NS, Hoffman GM. Pro: NIRS is "standard of care" for postoperative management. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2010, 13(1): 44-50.
4.	Grubhofer G, Lassnigg A, Manlik F, et al. The contribution of extracranial blood oxygenation on near-infrared spectroscopy during carotid thrombendarterectomy. Anaesthesia, 1997, 52(2): 116-120.
5.	杭燕南, 刘仁玉, 王祥瑞, 等. 脑氧饱和度监测的临床意义及评价. 中华麻醉学杂志, 1995, 15(6): 244-246.
6.	Stilo F, Spinelli F, Martelli E, et al. The sensibility and specificity of cerebral oximetry, measured by INVOS-4100, in patients undergoing carotid endarterectomy compared with awake testing. Minerva Anestesiol, 2012, 78(10): 1126-1135.
7.	Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation.Br J Anaesth, 2009, 103(Suppl 1): i3-13.
8.	Bevan PJ. Should cerebral near-infrared spectroscopy be standard of care in adult cardiac surgery? Heart Lung Circ, 2015, 24(6): 544-550.
9.	Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Semin Cardiothorac Vasc Anesth, 2007, 11(4): 274-281.
10.	Schindler E, Zickmann B, Müller M, et al. Cerebral oximetry by infrared spectroscopy in comparison with continuous measurement of oxygen saturation of the jugular vein bulb in interventions of the internal carotid artery. Vasa, 1995, 24(2): 168-175.
11.	Ikeda K, MacLeod DB, Grocott HP, et al. The accuracy of a near-infrared spectroscopy cerebral oximetry device and its potential value for estimating jugular venous oxygen saturation. Anesth Analg, 2014, 119(6): 1381-1392.
12.	Kumagai M,Ogawa S, Doe A, et al. Cerebral oxygenation measured by near-infrared spectroscopy and jugular vein oxygen saturation during robotic-assisted laparoscopic radical prostatectomy under total intravenous anaesthesia. Int J Med Robot, 2014 Oct 21. doi: 10.1002/rcs.1629. [Epub ahead of print].
13.	Murphy N, Frohlich S, Kong T, et al. Utility of near infrared light to determine tissue oxygenation during hepato-biliary surgery. J Clin Monit Comput, 2015, 29(5): 613-619.
14.	Ruffer A, Tischer P, Munch F, et al. Comparable cerebral blood flow in both hemispheres during regional cerebral perfusion in infant aortic arch surgery. Ann Thorac Surg, 2017, 103(1): 178-185.
15.	Murkin JM. Perioperative detection of brain oxygenation and clinical outcomes in cardiac surgery. Semin Cardiothorac Vasc Anesth, 2004, 8(1): 13-14.
16.	Murkin JM. Cerebral oximetry: monitoring the brain as the index organ. Anesthesiology, 2011, 114(1): 12-13.
17.	Ghanayem NS, Hoffman GM. Near infrared spectroscopy as a hemodynamic monitor in critical illness. Pediatr Crit Care Med, 2016, 17(8 Suppl 1): S201-206.
18.	Taillefer MC, Denault AY. Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy. Can J Anaesth, 2005, 52(1): 79-87.
19.	Murkin JM, Adams SJ, Novick RJ, et al. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg, 2007, 104(1): 51-58.
20.	Goldman S, Sutter F, Ferdinand F, et al. Optimizing intraoperative cerebral oxygen delivery using noninvasivecerebral oximetry decreases the incidence of stroke for cardiac surgical patients. Heart Surg Forum, 2004, 7(5): E376-381.
21.	Oemrawsingh RM, Cheng JM, Garcia-Garcia HM, et al. Near-infrared spectroscopy predicts cardiovascular outcome in patients with coronary artery disease. J Am Coll Cardiol, 2014, 64(23): 2510-2518.
22.	Zheng F, Sheinberg R, Yee MS, et al. Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg, 2013, 116(3): 663-676.
23.	曹莉, 于钦军, Edmonds J HL Jr. 65 岁以上病人冠状动脉搭桥术中脑氧饱和度的变化与术后神经功能障碍的关系. 中华老年心脑血管病杂志, 2000, 2(6): 395-397.
24.	Colak Z, Borojevic M, Bogovic A, et al. Influence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized, prospective study. Eur J Cardiothorac Surg, 2015, 47(3): 447-454.
25.	Subramanian B, Nyman C, Fritock M, et al. A Multicenter pilot study assessing regional cerebral oxygen desaturation frequency duringcardiopulmonary bypass and responsiveness to an intervention algorithm. Anesth Analg, 2016, 122(6): 1786-1793.
26.	Lin R, Zhang F, Xue Q, et al. Accuracy of regional cerebral oxygen saturation in predicting postoperative cognitive dysfunction after total hip arthroplasty: regional cerebral oxygen saturation predicts POCD. J Arthroplasty, 2013, 28(3): 494-497.
27.	Ono M, Brady K, Easley RB, et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. J Thorac Cardiovasc Surg, 2014, 147(1): 483-489.
28.	Ishikawa S, Lohser J. One-lung ventilation and arterial oxygenation. Curr Opin Anaesthesiol, 2011, 24(1): 24-31.
29.	Kazan R, Bracco D, Hemmerling TM. Reduced cerebral oxygen saturation measured by absolute cerebral oximetry during thoracic surgery correlates with postoperative complications. Br J Anaesth, 2009, 103(6): 811-816.
30.	Tobias JD, Johnson GA, Rehman S, et al. Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults. J Minim Access Surg, 2008, 4(4): 104-107.
31.	丁超, 孙莉, 张燕. 老年食管癌患者单肺通气期间局部脑氧饱和度的变化及影响因素分析.中国医刊, 2012, 47(3): 47-50.
32.	Staalsø JM, Rokamp KZ, Olesen ND, et al. ADRB2 gly16gly genotype, cardiac output, and cerebral oxygenation in patients undergoing anesthesia for abdominal aortic aneurysm surgery. Anesth Analg, 2016, 123(6): 1408-1415.
33.	Ishikawa S, Shirasawa M, Fujisawa M, et al. Compressing the non-dependent lung during one-lung ventilation improves arterial oxygenation, but impairs systemic oxygen delivery by decreasing cardiac output. J Anesth, 2010, 24(1): 17-23.
34.	Ramasco F, Mendez R, Planas A, et al. Evolution of regional oxygen saturation in the peri-operative of thoracic surgery and its relationship with central venous saturation. Rev Esp Anestesiol Reanim, 2016, 63(8): 438-443.
35.	Brinkman R, Amadeo RJ, Funk DJ, et al. Cerebral oxygen desaturation during one-lung ventilation: correlation with hemodynamic variables. Can J Anaesth, 2013, 60(7): 660-666.
36.	Santos FS, Velasco IT, Fraguas R, et al. Risk factors for delirium in the elderly after coronary artery bypass graft surgery. Int Psychogeriatr, 2004, 16(2): 175-193.
37.	Tang L, Kazan R, Taddei R, et al. Reduced cerebral oxygen saturation during thoracic surgery predicts early postoperative cognitive dysfunction. Br J Anaesth, 2012, 108(4): 623-629.
38.	Li XM, Li F, Liu ZK, et al. Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations. J Zhejiang Univ Sci B, 2015, 16(12): 1042-1048.
39.	周民伟, 聂玉初, 洪勇, 等. 单肺通气手术患者 POCD 危险因素分析. 临床军医杂志, 2012, 40(5): 1075-1077.
40.	Mahal I, Davie SN, Grocott HP. Cerebral oximetry and thoracic surgery. Curr Opin Anaesthesiol, 2014, 27(1): 21-27.
41.	Egawa J, Inoue S, Nishiwada T, et al. Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial. Can J Anaesth, 2016, 63(10): 1161-1169.
42.	Ackland GL, Iqbal S, Paredes LG, et al. Individualised oxygen delivery targeted haemodynamic therapy in high-risk surgical patients: a multicentre, randomised, double-blind, controlled, mechanistic trial. Lancet Respir Med, 2015, 3(1): 33-41.

1. Jobsis FF. Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science, 1977, 198(4323): 1264-1267.
2. De Blasi RA, Ferrari M, Natali A, et al. Noninvasive measurement of forearm blood flow and oxygen consumption by near-infrared spectroscopy. J Appl Physiol, 1994, 76(3): 1388-1393.
3. Tweddell JS, Ghanayem NS, Hoffman GM. Pro: NIRS is "standard of care" for postoperative management. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2010, 13(1): 44-50.
4. Grubhofer G, Lassnigg A, Manlik F, et al. The contribution of extracranial blood oxygenation on near-infrared spectroscopy during carotid thrombendarterectomy. Anaesthesia, 1997, 52(2): 116-120.
5. 杭燕南, 刘仁玉, 王祥瑞, 等. 脑氧饱和度监测的临床意义及评价. 中华麻醉学杂志, 1995, 15(6): 244-246.
6. Stilo F, Spinelli F, Martelli E, et al. The sensibility and specificity of cerebral oximetry, measured by INVOS-4100, in patients undergoing carotid endarterectomy compared with awake testing. Minerva Anestesiol, 2012, 78(10): 1126-1135.
7. Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation.Br J Anaesth, 2009, 103(Suppl 1): i3-13.
8. Bevan PJ. Should cerebral near-infrared spectroscopy be standard of care in adult cardiac surgery? Heart Lung Circ, 2015, 24(6): 544-550.
9. Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Semin Cardiothorac Vasc Anesth, 2007, 11(4): 274-281.
10. Schindler E, Zickmann B, Müller M, et al. Cerebral oximetry by infrared spectroscopy in comparison with continuous measurement of oxygen saturation of the jugular vein bulb in interventions of the internal carotid artery. Vasa, 1995, 24(2): 168-175.
11. Ikeda K, MacLeod DB, Grocott HP, et al. The accuracy of a near-infrared spectroscopy cerebral oximetry device and its potential value for estimating jugular venous oxygen saturation. Anesth Analg, 2014, 119(6): 1381-1392.
12. Kumagai M,Ogawa S, Doe A, et al. Cerebral oxygenation measured by near-infrared spectroscopy and jugular vein oxygen saturation during robotic-assisted laparoscopic radical prostatectomy under total intravenous anaesthesia. Int J Med Robot, 2014 Oct 21. doi: 10.1002/rcs.1629. [Epub ahead of print].
13. Murphy N, Frohlich S, Kong T, et al. Utility of near infrared light to determine tissue oxygenation during hepato-biliary surgery. J Clin Monit Comput, 2015, 29(5): 613-619.
14. Ruffer A, Tischer P, Munch F, et al. Comparable cerebral blood flow in both hemispheres during regional cerebral perfusion in infant aortic arch surgery. Ann Thorac Surg, 2017, 103(1): 178-185.
15. Murkin JM. Perioperative detection of brain oxygenation and clinical outcomes in cardiac surgery. Semin Cardiothorac Vasc Anesth, 2004, 8(1): 13-14.
16. Murkin JM. Cerebral oximetry: monitoring the brain as the index organ. Anesthesiology, 2011, 114(1): 12-13.
17. Ghanayem NS, Hoffman GM. Near infrared spectroscopy as a hemodynamic monitor in critical illness. Pediatr Crit Care Med, 2016, 17(8 Suppl 1): S201-206.
18. Taillefer MC, Denault AY. Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy. Can J Anaesth, 2005, 52(1): 79-87.
19. Murkin JM, Adams SJ, Novick RJ, et al. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg, 2007, 104(1): 51-58.
20. Goldman S, Sutter F, Ferdinand F, et al. Optimizing intraoperative cerebral oxygen delivery using noninvasivecerebral oximetry decreases the incidence of stroke for cardiac surgical patients. Heart Surg Forum, 2004, 7(5): E376-381.
21. Oemrawsingh RM, Cheng JM, Garcia-Garcia HM, et al. Near-infrared spectroscopy predicts cardiovascular outcome in patients with coronary artery disease. J Am Coll Cardiol, 2014, 64(23): 2510-2518.
22. Zheng F, Sheinberg R, Yee MS, et al. Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg, 2013, 116(3): 663-676.
23. 曹莉, 于钦军, Edmonds J HL Jr. 65 岁以上病人冠状动脉搭桥术中脑氧饱和度的变化与术后神经功能障碍的关系. 中华老年心脑血管病杂志, 2000, 2(6): 395-397.
24. Colak Z, Borojevic M, Bogovic A, et al. Influence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized, prospective study. Eur J Cardiothorac Surg, 2015, 47(3): 447-454.
25. Subramanian B, Nyman C, Fritock M, et al. A Multicenter pilot study assessing regional cerebral oxygen desaturation frequency duringcardiopulmonary bypass and responsiveness to an intervention algorithm. Anesth Analg, 2016, 122(6): 1786-1793.
26. Lin R, Zhang F, Xue Q, et al. Accuracy of regional cerebral oxygen saturation in predicting postoperative cognitive dysfunction after total hip arthroplasty: regional cerebral oxygen saturation predicts POCD. J Arthroplasty, 2013, 28(3): 494-497.
27. Ono M, Brady K, Easley RB, et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. J Thorac Cardiovasc Surg, 2014, 147(1): 483-489.
28. Ishikawa S, Lohser J. One-lung ventilation and arterial oxygenation. Curr Opin Anaesthesiol, 2011, 24(1): 24-31.
29. Kazan R, Bracco D, Hemmerling TM. Reduced cerebral oxygen saturation measured by absolute cerebral oximetry during thoracic surgery correlates with postoperative complications. Br J Anaesth, 2009, 103(6): 811-816.
30. Tobias JD, Johnson GA, Rehman S, et al. Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults. J Minim Access Surg, 2008, 4(4): 104-107.
31. 丁超, 孙莉, 张燕. 老年食管癌患者单肺通气期间局部脑氧饱和度的变化及影响因素分析.中国医刊, 2012, 47(3): 47-50.
32. Staalsø JM, Rokamp KZ, Olesen ND, et al. ADRB2 gly16gly genotype, cardiac output, and cerebral oxygenation in patients undergoing anesthesia for abdominal aortic aneurysm surgery. Anesth Analg, 2016, 123(6): 1408-1415.
33. Ishikawa S, Shirasawa M, Fujisawa M, et al. Compressing the non-dependent lung during one-lung ventilation improves arterial oxygenation, but impairs systemic oxygen delivery by decreasing cardiac output. J Anesth, 2010, 24(1): 17-23.
34. Ramasco F, Mendez R, Planas A, et al. Evolution of regional oxygen saturation in the peri-operative of thoracic surgery and its relationship with central venous saturation. Rev Esp Anestesiol Reanim, 2016, 63(8): 438-443.
35. Brinkman R, Amadeo RJ, Funk DJ, et al. Cerebral oxygen desaturation during one-lung ventilation: correlation with hemodynamic variables. Can J Anaesth, 2013, 60(7): 660-666.
36. Santos FS, Velasco IT, Fraguas R, et al. Risk factors for delirium in the elderly after coronary artery bypass graft surgery. Int Psychogeriatr, 2004, 16(2): 175-193.
37. Tang L, Kazan R, Taddei R, et al. Reduced cerebral oxygen saturation during thoracic surgery predicts early postoperative cognitive dysfunction. Br J Anaesth, 2012, 108(4): 623-629.
38. Li XM, Li F, Liu ZK, et al. Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations. J Zhejiang Univ Sci B, 2015, 16(12): 1042-1048.
39. 周民伟, 聂玉初, 洪勇, 等. 单肺通气手术患者 POCD 危险因素分析. 临床军医杂志, 2012, 40(5): 1075-1077.
40. Mahal I, Davie SN, Grocott HP. Cerebral oximetry and thoracic surgery. Curr Opin Anaesthesiol, 2014, 27(1): 21-27.
41. Egawa J, Inoue S, Nishiwada T, et al. Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial. Can J Anaesth, 2016, 63(10): 1161-1169.
42. Ackland GL, Iqbal S, Paredes LG, et al. Individualised oxygen delivery targeted haemodynamic therapy in high-risk surgical patients: a multicentre, randomised, double-blind, controlled, mechanistic trial. Lancet Respir Med, 2015, 3(1): 33-41.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The application of cerebral oxygen saturation monitoring in cardiac and thoracic surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content