Near-infrared spectroscopy (NIRS) is non-invasive, easy to use, and offers real-time
monitoring of the oxygen content of cerebral tissue. An effective and user-friendly
method of cerebral monitoring stands to offer a significant advance in patient care
during adult cardiac surgery, particularly for surgery in which the continuity of
cerebral vessels may be compromised. While the current evidence does not definitively
show improvement in neurological outcomes, it can be argued that the overall risk
to benefit ratio falls on the side of NIRS.
NIRS also gives information about the oxygenation of systemic tissues. It may be that
in surgery that does not involve the aortic arch, the value of NIRS will be in increased
individualisation of patient management and improved systemic perfusion, impacting
general outcomes as much as neurological outcomes.
This review will summarise the need for neuromonitoring and the principles of NIRS.
It will examine the thresholds used to define desaturation, the evidence for clinical
benefit from NIRS, and the criticisms and limitations of NIRS. It will also discuss
the uses of NIRS beyond improving neurological outcomes alone.
Keywords
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Article info
Publication history
Published online: February 06, 2015
Accepted:
January 19,
2015
Received:
December 1,
2014
Identification
Copyright
© 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
