Utility of near infrared light to determine tissue oxygenation during hepato-biliary surgery

Near-infrared spectrophotometry assesses cerebral oxygen saturation (S c O 2 ) based on the absorption spectra of oxygenated and deoxygenated hemoglobin, and the translucency of biological tissue, in the near-infrared band. There is increasing evidence that optimising cerebral oxygenation, guided by...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing 2015-10, Vol.29 (5), p.613-619
Main Authors: Murphy, N., Fröhlich, S., Kong, T., Boylan, J. F., Conlon, N.
Format: Article
Language:English
Subjects:
Aged
Anesthesiology
Brain - metabolism
Critical Care Medicine
Female
Health Sciences
Humans
Intensive
Lighting - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Monitoring
Monitoring, Intraoperative - methods
Original Research
Oximetry
Oximetry - methods
Oxygen - blood
Oxygen content
Oxygenation
Pancreatectomy - methods
Patients
Reproducibility of Results
Risk
Saturation
Sensitivity and Specificity
Spectroscopy, Near-Infrared - methods
Statistics for Life Sciences
Surgery
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Summary:Near-infrared spectrophotometry assesses cerebral oxygen saturation (S c O 2 ) based on the absorption spectra of oxygenated and deoxygenated hemoglobin, and the translucency of biological tissue, in the near-infrared band. There is increasing evidence that optimising cerebral oxygenation, guided by S c O 2 , is associated with improved outcomes in a variety of high risk surgical settings. However, in patients with liver disease, bilirubin can potentially render cerebral oximetry inaccurate. As a result, measurement of cerebral oxygen saturation is rarely undertaken in patients undergoing hepatobiliary surgery. We prospectively measured baseline and intraoperative cerebral oxygen saturation in patients undergoing major pancreatic surgery. Indices including bilirubin, sodium, platelets and maximum amplitude on thromboelastography were associated with low baseline S c O 2 . However, those patients with low S c O 2 (≤51 %) maintained a similar trend in cerebral oximetry values both at induction and intraoperatively to those with a normal S c O 2 . We conclude that the pattern of cerebral oximetry is similar in patients undergoing major pancreatic surgery regardless of their underlying liver dysfunction. Therefore, cerebral oximetry may have a role in monitoring neurological function in this high risk group of patients.
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-014-9642-y