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Seminars in Cardiothoracic and Vascular Anesthesia
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A Proposed Algorithm for the Intraoperative Use of Cerebral Near-Infrared Spectroscopy

André Denault, MD, FRCPC, ABIM-CCM

Department of Anesthesiology, Montreal Heart Institute, Montreal, Quebec, denault{at}videotron.ca

Alain Deschamps, MD, FRCPC, PhD

Department of Anesthesiology, Montreal Heart Institute, Montreal, Quebec

John M. Murkin, MD, FRCPC

Department of Anesthesiology and Perioperative Medicine, University Hospital, University of Western Ontario, London, Ontario Canada

Near-infrared spectroscopy (NIRS) is a technique that can be used as a noninvasive and continuous monitor of the balance between cerebral oxygen delivery and consumption. The authors develop and propose an algorithm for the use of NIRS based on optimizing factors that can affect cerebral oxygen supply/demand. These factors are the position of the vascular cannula, perfusion pressure, arterial oxygen content, partial pressure of carbon dioxide, haemoglobin, cardiac output, and the cerebral metabolic rate of oxygen. Dissemination of a useful treatment algorithm is the primary purpose of this article. Further multicenter studies are necessary to confirm the benefits and cost-effectiveness of this promising monitoring modality.

Key Words: near-infrared spectroscopy • brain oximetry • neurological monitoring • cardiopulmonary bypass

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 11, No. 4, 274-281 (2007)
DOI: 10.1177/1089253207311685
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