Key result
Cerebral oximetry using NIRS showed positive and negative predictive values of 50% and 67% for detecting tissue perfusion-related adverse outcomes during cardiac surgery.
Why the study?
The authors sought to evaluate cerebral and somatic oximetry as part of an integrated tissue perfusion monitoring strategy in cardiac surgery.
Does NIRS cerebral desaturation accurately predict global perfusion-related adverse clinical events in adult patients undergoing cardiac surgery with MiECC?
Observational (n=30)
Does NIRS cerebral desaturation accurately predict global perfusion-related adverse clinical events in adult patients undergoing cardiac surgery with MiECC?
NIRS cerebral oximetry is a useful tissue perfusion monitoring tool during cardiac surgery, with specific desaturation cutoffs correlating with hyperlactemia to prompt early intervention.
Modest predictive values of cerebral oximetry warrant caution against sole reliance for perfusion assessment; leaves open its adjunctive utility pending validation studies.
Introduction We sought to evaluate cerebral and somatic oximetry in an integrated tissue perfusion monitoring strategy. Method Thirty adult patients undergoing full-spectrum cardiac surgery with Minimal Invasive Extracorporeal Circulation (MiECC) were recruited. We simultaneously assessed the adequacy of tissue perfusion with near-infrared spectroscopy (NIRS) for cerebral and tissue oximetry, cerebral autoregulation monitoring (COx), sublingual microcirculation with video microscopy and real-time in-line metabolic monitoring during cardiopulmonary bypass. The primary endpoint of the study was to evaluate the diagnostic accuracy of NIRS cerebral desaturation in predicting a global perfusion-related adverse clinical event. Results Cerebral oximetry showed the higher positive and negative predicting values (50% and 67%, respectively) in detecting a tissue perfusion-related adverse outcome. Somatic oximetry was related to higher values compared to cerebral ( p < .001) and followed a different trend. ROC analysis calculated a cutoff value of 22 for right-sided cerebral desaturation and 32 for cumulative left- and right-sided desaturation as a sensitive predictor of hyperlactemia. Microcirculatory parameters were impaired after induction of anesthesia, while they were preserved during cardiopulmonary bypass. Conclusions NIRS cerebral oximetry represents a useful tissue perfusion monitoring tool. An AUC cutoff value of 22 for a single hemisphere and 32 bilaterally correlate with hyperlactemia and may serve as alarm for prompt action.
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Antonitsis et al. (2025) conducted an observational in Cardiac surgery (n=30). Cerebral and somatic near-infrared spectroscopy (NIRS) was evaluated on Diagnostic accuracy of NIRS cerebral desaturation in predicting a global perfusion-related adverse clinical event. Cerebral oximetry using NIRS showed positive and negative predictive values of 50% and 67% for detecting tissue perfusion-related adverse outcomes during cardiac surgery.
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