Additional applications of intraoperative cerebral oxygenation monitoring using near infrared spectroscopy.

One of the major goals of intraoperative care is the maintenance of adequate cardiac output and delivery of oxygen to the tissues. Standard intraoperative monito- ring includes the non-invasive measurement of blood pressure (NIBP) and the use of pulse oximetry to moni- tor systemic oxygenation. Although generally effective, these monitors may fail. Monitors of tissue oxygenation such as cerebral oximetry using near infrared spectro- scopy (NIRS) are being used more commonly in ane- sthesia practice. Clinical use in both adult and pediatric patients has demonstrated the potential utility of these devices in monitoring cerebral and tissue oxygenation. We report two pediatric patients in whom NIRS monito- ring was used as the primary monitor of perfusion and cardiac output for a significant portion of the surgical procedure when other non-invasive monitors either fai- led or could not be used due to patient-related issues. The potential perioperative uses of NIRS monitoring are reviewed and these unique applications discussed.