Department of General Anesthesiology, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Department of Anesthesiology and Intensive Care Medicine, University of Rome 'La Sapienza', Rome, Italy.
J Neurosurg Anesthesiol. 2019 Oct;31(4):378-384. doi: 10.1097/ANA.0000000000000522.
Cerebral near-infrared spectroscopy (NIRS) is considered a valuable noninvasive modality for cerebral oxygenation monitoring during cardiovascular surgery and cardiac arrest. We assessed the capability of cerebral NIRS to predict cerebral desaturation and the related neurological outcomes in neurosurgical patients. A literature search in different electronic medical databases was performed from inception to January 2018. A total of 286 citations were found and finally 48 studies were retrieved, only 7 of these were eligible and included for review. A meta-analysis was not feasible because of high heterogeneity of patients' groups, different NIRS techniques used in the studies and different outcome criteria selected. The qualitative assessment showed controversial data on the threshold value of cerebral near-infrared spectroscopy used for detecting cerebral ischemia in neurosurgical patients. The evidence on the selected studies is not strong enough, at the moment, to recommend cerebral NIRS as a mandatory monitor to detect cerebral deoxygenation able to predict the future neurological outcome in neurosurgical patients. Further studies are needed to validate a threshold value for cerebral ischemia and the relationship between NIRS-detected cerebral desaturation and clinical outcome in the neurosurgical population.
脑近红外光谱（NIRS）被认为是一种有价值的非侵入性监测方法，可用于心血管手术和心脏骤停期间的脑氧合监测。我们评估了脑 NIRS 预测神经外科患者脑饱和度降低和相关神经结局的能力。从最初到 2018 年 1 月，在不同的电子医学数据库中进行了文献检索。共发现 286 篇引文，最终检索到 48 项研究，但只有 7 项符合条件并纳入综述。由于患者组的高度异质性、研究中使用的不同 NIRS 技术和选择的不同结果标准，无法进行荟萃分析。定性评估显示，在神经外科患者中使用脑近红外光谱检测脑缺血的阈值存在争议性数据。目前，关于选择研究的证据还不够强，无法推荐脑 NIRS 作为一种强制性监测手段，以检测能够预测神经外科患者未来神经结局的脑缺氧。需要进一步的研究来验证脑缺血的阈值以及 NIRS 检测到的脑饱和度与神经外科人群临床结局之间的关系。
