The use of cerebral oximetry in surgery: A systematic review and meta-analysis of randomized controlled trials

Wong, Zhen Zhe and Chiong, Xin Hui and Chaw, Sook Hui and Md Hashim, Noorjahan Haneem and Zainal Abidin, Mohd Fitry and Yunus, Siti Nadzrah and Subramaniam, Thiruselvi and Ng, Ka Ting (2022) The use of cerebral oximetry in surgery: A systematic review and meta-analysis of randomized controlled trials. Journal of Cardiothoracic and Vascular Anesthesia, 36 (7). pp. 2002-2011. ISSN 1053-0770, DOI

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Objective: The evidence on the use of cerebral oximetry during surgery to minimize postoperative neurologic complications remains uncertain in the literature. The present authors aimed to assess the value of cerebral oximetry in the prevention of postoperative cognitive dysfunction, postoperative delirium, and postoperative stroke in adults undergoing surgery. Design: A systematic review and meta-analysis. Setting: The surgery room. Participants: Adult patients (ages >= 18 years) undergoing surgery. Interventions: Cerebral oximetry monitoring. Measurements and Main Results: Databases of Ovid MEDLINE, Ovid EMBASE, and CENTRAL were systematically searched from their inception until December 2020 for randomized controlled trials comparing cerebral oximetry monitoring with either blinded or no cerebral oximetry monitoring in adults undergoing surgery. Observational studies, case reports, and case series were excluded. Seventeen studies (n = 2,120 patients) were included for quantitative meta-analysis. Patients who were randomized to cerebral oximetry monitoring had a lower incidence of postoperative cognitive dysfunction (studies = seven, n = 969, odds ratio OR] 0.23, 95% confidence interval CI] 0.11-0.48, p = 0.0001; evidence = very low). However, no significant differences were observed in the incidence of postoperative delirium (studies = five, n = 716, OR 0.81, 95% CI 0.53-1.25, p = 0.35; evidence = high), and postoperative stroke (studies = seven, n = 1,087, OR 0.72, 95% CI 0.30-1.69, p = 0.45; evidence = moderate). Conclusion: Adult patients with cerebral oximetry monitoring were associated with a significant reduction of postoperative cognitive dysfunction. However, given the low certainty of evidence and substantial heterogeneity, more randomized controlled trials using standardized assessment tools for postoperative cognitive dysfunction and interventions of correcting cerebral desaturation are warranted to improve the certainty of evidence and homogeneity. (C) 2021 Elsevier Inc. All rights reserved.

Item Type: Article
Funders: None
Uncontrolled Keywords: Cerebral oximetry; NIRS monitoring; Surgery; Cognitive dysfunction; Delirium
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Medicine > Anaesthesiology Department
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 26 Oct 2023 06:20
Last Modified: 26 Oct 2023 06:20

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