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A Comprehensive Review of Cerebral Oximetry in Cardiac Surgery
  • Christina Moore,
  • Soojie Yu,
  • Oscar Aljure
Christina Moore
University of Miami School of Medicine
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Soojie Yu
Mayo Clinic Phoenix AZ USA
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Oscar Aljure
University of Miami School of Medicine
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Abstract

Background: Patients who undergo cardiac surgery are at increased risk of stroke, postoperative cognitive decline, and delirium. These neurocognitive complications have led to increased costs, intensive care unit stays, morbidity, and mortality. As a result, there is a significant push to mitigate any neurological complications in cardiac surgery patients. Near-infrared spectroscopy to measure regional cerebral oxygen saturations has gained consideration due to its non-invasive, user-friendly, and relatively inexpensive nature. Aim of Study: To provide a comprehensive summary of cerebral oximetry in cardiac surgery. The review interrogates multiple systematic reviews assessing different outcomes in cardiac surgery to assess if cerebral oximetry is effective. Further, the review analyzes all available interventions for an acute desaturation to determine the efficacy of individual interventions. Methods: A narrative review of randomized controlled trials, observational studies, and systematic reviews with metanalyses were performed through August 2021. Results: There is significant heterogeneity amongst studies regarding the definition of a clinically significant cerebral desaturation. In addition, the assessment of neurocognitive outcomes has large variability, making metanalysis challenging. To date, cerebral oximetry use during cardiac surgery has not been associated with improvements in neurocognitive outcomes, morbidity, or mortality. The evidence to support particular interventions for an acute desaturation is equivocal. Conclusions: Future research is needed to quantify a clinically significant cerebral desaturation and to determine which interventions for an acute desaturation effectively improve clinical outcomes.
02 Dec 2021Submitted to Journal of Cardiac Surgery
02 Dec 2021Submission Checks Completed
02 Dec 2021Assigned to Editor
04 Dec 2021Reviewer(s) Assigned
04 Jan 2022Review(s) Completed, Editorial Evaluation Pending
06 Jan 2022Editorial Decision: Revise Major
24 Feb 20221st Revision Received
25 Feb 2022Submission Checks Completed
25 Feb 2022Assigned to Editor
25 Feb 2022Reviewer(s) Assigned
19 Apr 2022Review(s) Completed, Editorial Evaluation Pending
19 Apr 2022Editorial Decision: Revise Major
21 May 20222nd Revision Received