高危手术患者的脑氧饱和度:我们进展到哪里了?

IF 3.5 3区 医学 Q1 CRITICAL CARE MEDICINE
Current Opinion in Critical Care Pub Date : 2024-12-01 Epub Date: 2024-09-04 DOI:10.1097/MCC.0000000000001204
Rosalia Navarro-Perez, Nekane Romero-García, Camilla Paolessi, Chiara Robba, Rafael Badenes
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引用次数: 0

摘要

综述目的:本综述旨在总结近红外光谱(NIRS)在高风险手术患者(包括心脏和非心脏手术)脑氧饱和度监测中的作用的最新证据,并提出一种新的应用算法:最近的研究结果:近红外成像技术能有效测量无创的脑氧饱和度,在心脏手术中对减少神经系统并发症很有价值,但对非神经系统结果的影响还不太清楚。在非心脏手术中,近红外成像技术有助于预防术后认知功能障碍等并发症,尤其是在高风险和重大手术中。研究强调了手术体位对脑氧饱和度影响的差异性,沙滩椅和坐姿等体位的结果不一。总结:尽管存在空间分辨率和个体间变异性等局限性,近红外成像仍不失为术中脑部监测的有用工具。需要进一步的研究来确认其在非心脏手术中的广泛适用性,但目前的证据支持其在减少术后并发症方面的作用,尤其是在心脏手术中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cerebral oximetry in high-risk surgical patients: where are we?

Purpose of review: This review aims to summarize the latest evidence on the role of near-infrared spectroscopy (NIRS) in monitoring cerebral oxygenation in high-risk surgical patients, including both cardiac and noncardiac surgeries, and to present a new algorithm for its application.

Recent findings: NIRS effectively measures brain oxygen saturation noninvasively, proving valuable in cardiac surgeries to reduce neurological complications, though its impact on nonneurological outcomes is less clear. In noncardiac surgeries, NIRS can help prevent complications like postoperative cognitive dysfunction, particularly in high-risk and major surgeries. Studies highlight the variability of cerebral oxygenation impacts based on surgical positions, with mixed results in positions like the beach chair and sitting positions. A structured algorithm for managing cerebral desaturation has been proposed to optimize outcomes by addressing multiple factors contributing to blood oxygen content and delivery.

Summary: Despite its limitations, including spatial resolution and interindividual variability, NIRS is a useful tool for intraoperative cerebral monitoring. Further studies are needed to confirm its broader applicability in noncardiac surgeries, but current evidence supports its role in reducing postoperative complications especially in cardiac surgeries.

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来源期刊
Current Opinion in Critical Care
Current Opinion in Critical Care 医学-危重病医学
CiteScore
5.90
自引率
3.00%
发文量
172
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​​Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.
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