Utility of near infrared light to determine tissue oxygenation during hepato-biliary surgery

• Published in: Journal of clinical monitoring and computing Vol. 29; no. 5; pp. 613 - 619
• Main Authors: Murphy, N., Fröhlich, S., Kong, T., Boylan, J. F., Conlon, N.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.10.2015; Springer Nature B.V
• Subjects: Aged; Anesthesiology; Brain - metabolism; Critical Care Medicine; Female; Health Sciences; Humans; Intensive; Lighting - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Monitoring; Monitoring, Intraoperative - methods; Original Research; Oximetry; Oximetry - methods; Oxygen - blood; Oxygen content; Oxygenation; Pancreatectomy - methods; Patients; Reproducibility of Results; Risk; Saturation; Sensitivity and Specificity; Spectroscopy, Near-Infrared - methods; Statistics for Life Sciences; Surgery; Hepatobiliary; Bilirubin; Cerebral oximetry; Liver
• ISSN: 1387-1307; 1573-2614
• DOI: 10.1007/s10877-014-9642-y

Near-infrared spectrophotometry assesses cerebral oxygen saturation (S c O 2 ) based on the absorption spectra of oxygenated and deoxygenated hemoglobin, and the translucency of biological tissue, in the near-infrared band. There is increasing evidence that optimising cerebral oxygenation, guided by S c O 2 , is associated with improved outcomes in a variety of high risk surgical settings. However, in patients with liver disease, bilirubin can potentially render cerebral oximetry inaccurate. As a result, measurement of cerebral oxygen saturation is rarely undertaken in patients undergoing hepatobiliary surgery. We prospectively measured baseline and intraoperative cerebral oxygen saturation in patients undergoing major pancreatic surgery. Indices including bilirubin, sodium, platelets and maximum amplitude on thromboelastography were associated with low baseline S c O 2 . However, those patients with low S c O 2 (≤51 %) maintained a similar trend in cerebral oximetry values both at induction and intraoperatively to those with a normal S c O 2 . We conclude that the pattern of cerebral oximetry is similar in patients undergoing major pancreatic surgery regardless of their underlying liver dysfunction. Therefore, cerebral oximetry may have a role in monitoring neurological function in this high risk group of patients.