Cerebral oximetry and thoracic surgery

Cerebral oximetry, though first described for clinical use in cardiac surgery, has been increasingly used in the setting of thoracic surgery. Research focusing on the use of cerebral oximetry in this setting is relatively sparse. This review outlines our current understanding of the use of cerebral oximetry for thoracic surgery.

Cerebral desaturation, though variably defined, is a relatively common occurrence during thoracic surgery. The reasons for this desaturation largely relate to perioperative hypoxemia, but may also be related to other physiologic disturbances such as lateral decubitus positioning, one-lung ventilation, as well as other nonhypoxemia-related mechanisms. It is unlikely to result from specific reductions in cardiac output. There is some preliminary data suggesting a relationship between cerebral desaturation and various adverse postoperative outcomes.

Although it is clear that cerebral desaturation can commonly occur during thoracic surgery, it is partly dependent upon how desaturation is defined. The relationship between cerebral desaturation and adverse outcomes after thoracic surgery, as well as the potential ability for cerebral oximetry to guide therapeutic modalities, awaits much needed additional research before being more widely accepted.