Cerebral oximetry: the standard monitor of the future?

Objective: There is an increasing interest in the application of near-infrared spectroscopy (NIRS) as a monitoring tool in noncardiac surgery. This review summarizes the latest developments and current evidence for the use of NIRS in the noncardiac intraoperative setting.

Results: Unanticipated intraoperative physiological disturbances and a substantial interpatient variability in the limits of cerebral autoregulation, pose our patients at risk for adverse cerebral outcome, if the brain is not monitored specifically. In addition to a means to monitor the brain, NIRS has been shown to allow an estimate of overall organ oxygenation. Preliminary data suggest a relationship between cerebral desaturation and both neurologic and major organ morbidity.

Conclusions: NIRS offers noninvasive monitoring of cerebral and overall organ oxygenation in a wide range of clinical scenarios. There is an increasing evidence that the optimized cerebral oxygenation is associated with improved outcomes in both neurologic and major organ morbidity in a variety of surgical settings.