Review Articles

Cerebral Oximetry and Autoregulation during Cardiopulmonary Bypass: A Review

Departments of ^* Cardiothoracic Surgery; and
^† Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands

Address for correspondence: Nousjka P.A. Vranken, Maastricht University Medical Center, P. Debyelaan 25, P.O. box 5800, 6202 AZ Maastricht, The Netherlands. E-mail: nousjka.vranken@mumc.nl

Received: 20 November 2016
Accepted: 22 March 2017

Abstract

Postoperative neurological complications (PNCs) following cardiac surgery with cardiopulmonary bypass (CPB) is a detrimental complication, contributing to increased mortality rates and health care costs. To prevent intraoperative cerebral desaturations associated with PNC, continuous brain monitoring using near-infrared spectroscopy has been advocated. However, clear evidence for a defined desaturation threshold requiring intervention during CPB is still lacking. Since cerebral oximetry readings are nonspecific, cerebral tissue oxygenation values need to be interpreted with caution and in the context of all available clinical information. Therefore, maintaining an intact autoregulatory activity during CPB rather than solely focusing on regional cerebral oxygen saturation measurements will collectively contribute to optimization of patient care during CPB.