• Kati Bochmann, Massimiliano Meineri, Joerg K Ender, Konstantin von Aspern, Flo FornerAnnaADepartment of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Leipzig, Germany., Aniruddha R Janai, and Waseem Zakaria Aziz Zakhary.
• Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Leipzig, Germany; Resident physician, Internal medicine, Klinikum Chemnitz, Chemnitz, Germany.
• J. Cardiothorac. Vasc. Anesth. 2022 Jul 1; 36 (7): 2022-2030.

ObjectiveThe purpose of this study was to determine the incidence and types of interventions triggered during a drop of baseline near-infraredspectroscopy (NIRS) values in consecutive cardiac surgical patients.DesignA single-center, retrospective observational study.SettingA university-affiliated tertiary care center.ParticipantsThree thousand three hundred two consecutive cardiac surgical patients from October 2016 to August 2017 Interventions: None.Measurements And Main ResultsOf the 1,972 patients who met the inclusion criteria, 576 (29.2%) patients showed NIRS deviation of -20% from baseline. Interventions performed during the drop of baseline NIRS values were documented in 285 (14.4%) patients, with a total of 391 interventions. Three hundred fifteen (80%) interventions were triggered by a deviation in NIRS and concomitant changes in standard monitoring parameters. Seventy-six (20%) interventions were triggered by NIRS deviation alone, with no concomitant pathologic deviation in standard monitoring. A total of 279 (71%) interventions were performed on patients who had no recommendation for NIRS monitoring by current national guidelines. Out of these, 30 (7.7%) interventions (1.3% of all patients) were performed based on NIRS monitoring alone. The higher risk deviation group had longer intensive care unit and hospital lengths of stays (one and 15 days) and postoperative delirium when compared with the no-deviation group (zero and 13 days) Conclusions: The authors' data suggested that most interventions triggered during the drop of baseline values during routine use of NIRS would have also been triggered by the concomitant changes in standard monitoring parameters. Routine use of NIRS for all cardiac surgical patients still is debatable and needs to be evaluated in a large prospective trial.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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