Original ArticleNear-Infrared Spectroscopy in Adult Cardiac Surgery Patients: A Systematic Review and Meta-Analysis
Section snippets
Methods
A protocol for this review was registered prospectively and published as part of the PROSPERO International Prospective Register of Systematic Reviews (CRD42016038410).7
Medline, Embase, and the Cochrane Central Registry of Controlled Trials were searched through April 15, 2016 for randomized controlled trials (RCTs) that included the evaluation of baseline preoperative SctO2 with NIRS in adult cardiac surgery patients, using “brain,” “oxygenation,” and “cardiac surgery” as initial search terms (
Results
The search strategy identified 601 reports for review: 140 in Medline, 256 in Embase, and 205 in Cochrane Central Registry of Controlled Trials. Of these, 11 RCTs with 953 randomized participants were included in the review (Fig 1). Characteristics of the included studies are shown in Table 1.1, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 There was a wide variation in methodologic quality of the included studies, with only 1 RCT12 satisfying a low risk of bias in all domains. Five RCTs were deemed
Key Findings
The authors conducted a systematic review of all RCTs of interventions measuring and designed to modify NIRS-derived SctO2 during CPB in adult patients and identified 11 RCTs that reported relevant information. From these studies, the pooled mean baseline preoperative SctO2 of this clinically heterogenous cohort of cardiac surgical patients was found to be approximately 66%, with a wide reference range. Moreover, the following 4 interventions were observed to possibly improve intraoperative SctO
Conclusions
This systematic review showed that the normal baseline SctO2 of cardiac surgery patients from 11 identified RCTs was approximately 66%, with a wide reference range. Moreover, this review suggested that intraoperative SctO2 may be modulated by particular interventions and confirmed there is a paucity of data on postoperative SctO2. Finally, the review demonstrated that there is very little or no RCT-derived information on any association between changes in intraoperative or postoperative SctO2
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N.J. Glassford is supported by the Avant Doctors-in-Training Research Scholarship.