• Med Klin Intensivmed Notfmed · Nov 2015

    [Near-infrared spectroscopy during cardiopulmonary resuscitation and mechanical circulatory support: From the operating room to the intensive care unit].

    • D Wally and Corinna Velik-Salchner.
    • Universitätsklinik für Anästhesie und Intensivmedizin, Department für Operative Medizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
    • Med Klin Intensivmed Notfmed. 2015 Nov 1; 110 (8): 621-30.

    BackgroundNear infrared spectroscopy (NIRS) allows continuous measurement of cerebral regional oxygen saturation (rSO2). It is a weighted saturation value derived from approximately 70-75 % venous, 20-25 % arterial and 2.5-5 % capillary blood. In contrast to pulse oximetry, NIRS is independent of pulsatile flow. Therefore, it is also applicable during extracorporeal circulation, cardiopulmonary resuscitation (CPR), and hypothermia.ObjectivesThe purpose of this work is to describe the application of cerebral and somatic NIRS in cardiology and cardiac surgery patients in the operation room, during and after CPR, and during the intensive care unit stay.Materials And MethodsThis article is based on peer-reviewed literature from PubMed.ResultsInterventions based on decline of cerebral NIRS values during on-pump cardiac surgery can reduce major organ morbidity and mortality; however, the appearance of a postoperative cognitive dysfunction is scarcely influenced. Persisting of low cerebral oximetry values during resuscitation is a marker for not achieving return of spontaneous circulation under normothermia. NIRS is an additional method for monitoring that can be used during extracorporeal circulation.ConclusionNIRS is a rapidly available, user-friendly, and noninvasive method for continuous measurement of rSO2. NIRS provides additional information about tissue oxygenation especially during resuscitation and extracorporeal circulatory assist support. Recommendations concerning the use of NIRS for standard monitoring during resuscitation and mechanical circulatory support are not currently available. Further studies are required to show if use of NIRS can reduce pulse control and hands-off times during resuscitation and if use of NIRS can improve outcome after CPR and mechanical circulatory support.

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