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Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies
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Cerebral desaturation during shoulder arthroscopy: a prospective observational study.

Dane Salazar1, Benjamin W Sears, John Andre

  • 1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Health System, 2160 South First Avenue, Maywood, IL, 60153, USA, dsalazar@post.com.

Clinical Orthopaedics and Related Research
|April 23, 2013
PubMed
Summary

Eighteen percent of patients undergoing beach chair shoulder surgery experienced intraoperative cerebral desaturation events (CDEs). Near-infrared spectroscopy effectively identifies these events, potentially improving patient safety during surgery.

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Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Medical Devices

Background:

  • Beach chair position during arthroscopic shoulder surgery poses a risk of neurocognitive complications due to cerebral ischemia.
  • Understanding intraoperative cerebral desaturation events (CDEs) is crucial for patient safety.

Purpose of the Study:

  • To determine the incidence, timing, and magnitude of intraoperative CDEs in patients undergoing beach chair shoulder surgery.
  • To investigate if surgery length is an independent risk factor for intraoperative CDEs.

Main Methods:

  • Regional cerebral oxygen saturation (rSO2) was monitored using near-infrared spectroscopy in 51 patients.
  • CDEs were defined as a decrease in rSO2 of 20% or greater from baseline.

Main Results:

  • The incidence of intraoperative CDEs was 18% (9 of 51 patients).
  • CDEs occurred at a mean of 18 minutes postinduction, with a mean maximal decrease of 32% in rSO2.
  • No significant difference in surgery length was found between patients with and without CDEs.

Conclusions:

  • Cerebral oximetry via near-infrared spectroscopy enables early detection and management of reduced cerebral perfusion.
  • Protocols for detecting and reversing CDEs may enhance patient safety during beach chair shoulder surgery.