Cereral oximetry for pediatric anesthesia: Why do intelligent clinicians disagree?

Nicholette Kasman, Kenneth Martin Brady*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations

Abstract

Reflectance near-infrared spectroscopy has been used to measure cortical tissue oximetry for more than 30 years. In that time, many centers have adopted the routine use of the cerebral oximeter for children having repair of congenital heart lesions, while some prominent academic centers have resisted routine use of these monitors citing lack of definitive evidence for outcome benefit. In this review, we provide an overview of the method used to measure cerebral oximetry, as well as validation and clinical outcome data that have accrued from the use of cerebral oximeters. We discuss the peculiarities of evidentiary review for monitoring devices, and the confounding errors that occur when a monitor is evaluated as a therapeutic intervention. We outline the physiologic basis of cerebral desaturation and the shifts in practice that have occurred with implementation of NIRS monitoring.

Original languageEnglish (US)
Pages (from-to)473-478
Number of pages6
JournalPaediatric anaesthesia
Volume21
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • congenital heart disease
  • near-infrared spectroscopy
  • pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

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