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  • Title: Cerebral near-infrared spectroscopy in adult patients after cardiac surgery is not useful for monitoring absolute values but may reflect trends in venous oxygenation under clinical conditions.
    Author: Dullenkopf A, Baulig W, Weiss M, Schmid ER.
    Journal: J Cardiothorac Vasc Anesth; 2007 Aug; 21(4):535-9. PubMed ID: 17678780.
    Abstract:
    OBJECTIVE: Cerebral near-infrared spectroscopy (NIRS) was evaluated for use in monitoring global oxygenation in adult patients after cardiac surgery. DESIGN: Prospective, randomized clinical monitoring study. SETTING: Intensive care unit for cardiac surgery; university hospital. PARTICIPANTS: The study included 35 patients scheduled for cardiac surgery with insertion of a pulmonary artery catheter; patients with known cerebral-vascular perfusion disturbances were excluded. INTERVENTIONS: Noninvasive cerebral NIRS oxygen saturation (rSO(2)) and conventional intensive care monitoring parameters were assessed. MEASUREMENTS AND MAIN RESULTS: Simple regression analysis was used to assess the correlation of rSO(2) to hemodynamic parameters. There was fair-to-moderate intersubject correlation to hemoglobin concentration (r = 0.45, p < 0.0001) and mixed venous oxygen saturation (SmvO(2)) (r = 0.33, p < 0.0001). Sensitivity and specificity of rSO(2) to detect substantial (>or=1 standard deviation) changes in mixed venous oxygen saturation were 94% and 81%, respectively. CONCLUSIONS: Cerebral NIRS in adult patients might not be the tool to replace mixed venous oxygen monitoring. Further work has to be done to assess its potential to reflect intraindividual trends.
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