Regional cerebral oxygen saturation monitoring during spinal surgery in order to identify patients at risk for cerebral desaturation

Sniedze Murniece (Coresponding Author), Martin Soehle, Indulis Vanags, Biruta Mamaja

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: Near infrared spectroscopy (NIRS) devices are non-invasive and monitor cerebral oxygen saturation (rScO2) continuously. NIRS interventional protocol is available in order to avoid hypoxic brain injury. Methods: We recruited patients scheduled for spinal surgery (n = 44). rScO2 was monitored throughout the surgery using INVOS 4100 cerebral oximeter. If the rScO2 values dropped more than 20% below baseline, or there was an absolute drop to below 50%, NIRS interventional protocol was followed. Results: In two patients rScO2 decreased by more than 20% from baseline values. In one patient rScO2 decreased to below 50%. NIRS protocol was initiated. As the first step, correct head position was verified-in one patient rScO2 increased above the threshold value. In the two remaining patients, mean arterial pressure was raised by injecting Ephedrin boluses as the next step. rScO2 raised above threshold. Patients with desaturation episodes had longer medium time of the operation (114 ± 35 versus 200 ± 98 min, p = 0.01). Pearson's correlation showed a negative correlation between rScO2 and duration of operation (r = 0.9, p = 0.2). Receiver operating characteristic curve analysis showed blood loss to be a strong predictor for possible cerebral desaturation (Area under the curve (AUC): 0.947, 95%CI: 0.836-1.000, p = 0.04). Conclusion: Patients with higher blood loss might experience cerebral desaturation more often than spinal surgery patients without significant blood loss.

    Original languageEnglish
    Article number2069
    JournalApplied Sciences (Switzerland)
    Volume10
    Issue number6
    DOIs
    Publication statusPublished - 19 Mar 2020

    Keywords

    • Cerebral oximeter
    • Cerebral oxygen saturation
    • Near infrared spectroscopy
    • Spinal surgery

    Field of Science

    • 3.2 Clinical medicine

    Publication Type

    • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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