The role of noninvasive brain oximetry in adult critically ill patients without primary non-anoxic brain injury

Badenes, Rafael; Bogossian, Elisa Gouvêa; Chisbert, Vicente; Robba, Chiara; Oddo, Mauro; Taccone, Fabio Silvio; Matta, Basil F.

doi:10.23736/s0375-9393.21.15333-7

Cited by 10 publications

(6 citation statements)

References 87 publications

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“…We calculated the FI of our significant subgroup findings and found an FI of 2 for the high-dose IV vitamin C subgroup and 18 for the monotherapy subgroup. An FI of 18 for IV vitamin C monotherapy is considerably higher than the median FI of multicenter critical care trials (FI of 2) (4) or meta-analyses (FI of 12) (5). We suggest not overinterpreting the FI since most RCTs are designed to recruit the fewest number of patients required to detect an assumed effect size (6).…”

mentioning

confidence: 88%

Fragility Index and Trial Sequential Analysis for Randomized Controlled Studies Testing IV Vitamin C in Critically Ill Patients

Vargas

Servillo

2022

Critical Care Medicine

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might be limited and dependent on the specific device. Third, rSo 2 only assess frontal cerebral areas and might be inadequate to assess global rSo 2 . Also, positioning of the probe cannot be adjusted as in the case of Pbto 2 catheter, which could be placed close to the "at risk areas" for ischemia (6) according to brain imaging.These concerns clearly indicate that the use of invasive or noninvasive brain oxygenation monitoring to guide RBCs transfusion in ABI patients remains an interesting and valuable approach, but more data on its feasibility and reliability are required before recommending it in clinical practice.

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confidence: 88%

Fragility Index and Trial Sequential Analysis for Randomized Controlled Studies Testing IV Vitamin C in Critically Ill Patients

Vargas

Servillo

2022

Critical Care Medicine

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“…Another one is a specific impairment of cerebral perfusion, perhaps through hyperventilation, although then systemic effects should be apparent too (see Section 3). Finally, a shortcoming of near-infrared spectroscopy may be to blame: the technique also records extracranial tissue oxygenation (Badenes et al, 2021). It is reasonable to assume that subtle decreases of CO and BP will affect the noncerebral circulation well before the wellprotected cerebral circulation is allowed to suffer.…”

Section: Cerebral Perfusion In Vvsmentioning

confidence: 99%

The pathophysiology of vasovagal syncope: Novel insights

Dijk

Rossum

Thijs

2021

Autonomic Neuroscience

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Section: Introductionmentioning

confidence: 99%

“…[8] NIRS provides an index of regional oxygen saturation (rSO 2 ), [8] and can be used for noninvasive, continuous assessment of cerebral oxygenation. [9] Areas of application for cerebral NIRS monitoring are, for example, heart surgery and carotid endarterectomies. [10] In literature, there are only few studies investigating cerebral oxygenation as measured by NIRS in patients undergoing abdominal surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Pre- and intraoperative cerebral near-infrared spectroscopy and postoperative delirium: Results of a prospective cross-sectional trial

et al. 2022

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Postoperative delirium (PODE) is a serious complication that can occur during the first few days after surgery. A number of causes can make delirium more likely; one factor to consider is hypoxia during anesthesia. In this study, the pre-and intraoperative cerebral regional oxygen saturation (rSO 2 ) as measured by near-infrared spectroscopy (NIRS) was to be examined with regard to an association with the occurrence of PODE in patients undergoing major abdominal procedures. Data from 80 patients (33 women, 47 men) was examined. The mean age was 66.31 ± 10.55 years (between 42 and 84 years). Thirteen patients developed PODE. The preoperative rSO 2 values (P = .10) and the rSO 2 values during the steady state of anesthesia (P = .06) tended to be lower in the delirium group than in the non-delirium group. There was a significant correlation between the preoperative rSO 2 and the preoperative hemoglobin values (P < .001). The variance of rSO 2 during the steady state of anesthesia was significantly greater in the delirium group compared to the non-delirium group (P = .03). In two patients from the delirium group, rSO 2 dropped below 50%; they also had a minimum mean arterial pressure below 50 mm Hg, which could have disturbed cerebral autoregulation. The duration of rSO 2 decreases (>10%, >15%, >20%) and increases (>10%) compared to the preoperative values was not significantly different between patients with and without PODE. The results suggest that NIRS could be a useful monitoring method for patients undergoing abdominal surgical procedures, on the one hand to recognize patients with low pre-or intraoperative rSO 2 values, and on the other hand to detect changes in rSO 2 values during anesthesia.

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The role of noninvasive brain oximetry in adult critically ill patients without primary non-anoxic brain injury

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Cited by 10 publications

References 87 publications

Fragility Index and Trial Sequential Analysis for Randomized Controlled Studies Testing IV Vitamin C in Critically Ill Patients

Fragility Index and Trial Sequential Analysis for Randomized Controlled Studies Testing IV Vitamin C in Critically Ill Patients

The pathophysiology of vasovagal syncope: Novel insights

Pre- and intraoperative cerebral near-infrared spectroscopy and postoperative delirium: Results of a prospective cross-sectional trial

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