This blog post discusses the risks, potential complications, and costs of cerebral oxygen desaturation. It also explains how regional oximetry and early detection of changes in a patient’s cerebral oxygenation and end organ perfusion allows you to intervene faster. Earlier intervention may reduce postoperative complications, improve patient outcomes, and lower the economic impact on your hospital.3-7
Numerous clinical studies have shown that cerebral oxygen desaturation can lead to significant postoperative complications. These include:
Further negative outcomes of cerebral desaturation during cardiac surgery can include neurologic injury3,6,7 and renal failure.4
Surgical and postoperative complications from cerebral oxygen desaturation are costly in many ways. They can lead to additional procedures, longer ICU and hospital stays, and readmissions — which increase the cost of care:
Independent research has shown that 88% of cerebral desaturation events are reversible with standard clinical interventions.1 One study concludes that continual perfusion monitoring and immediate action to maintain optimal perfusion throughout the perioperative period can protect end-organ function. This strategy also improves patient outcomes after cardiac surgery.10 Other researchers have found that patients had a lower incidence of permanent stroke, less need for prolonged ventilation, and a shorter hospital stay — although patients in this cerebral oximetry intervention group were sicker and had more comorbidity.11
In a high-risk cardiac surgery population, cerebral desaturation as measured by cerebral oximetry was common. The desaturation was successfully reversed in the majority of patients with an interventional protocol. Monitoring and intervention were associated with a reduction in the total cerebral desaturation load during surgery.1
Connor Fox is a brain monitoring product specialist at Medtronic.
1. Deschamps A, Lambert J, Couture P, et al. Reversal of decreases in cerebral saturation in high-risk cardiac surgery. J Cardiothorac Vasc Anesth. 2013;27(6):1260-1266.
2. Schoen J, Husemann L, Tiemeyer C, et al. Cognitive function after sevoflurane- vs propofol-based anaesthesia for on-pump cardiac surgery: a randomized controlled trial. Br J Anaesth. 2011;106(6):840-850.
3. Colak Z, Borojevic M, Bogovic A, Ivancan V, Biocina B, Majeric-Kogler V. Influence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized, prospective study. Eur J Cardiothorac Surg. 2015;47(3):447-454.
4. Murkin JM, Adams SJ, Novick RJ, et al. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg. 2007;104(1):51-58.
5. Schon J, V S, Hanke T, et al. Cerebral oxygen saturation monitoring in on-pump cardiac surgery – A 1 year experience. Vol 132009.
6. Slater JP, Guarino T, Stack J, et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg. 2009;87(1):36-44; discussion 44-35.
7. Yao FS, Tseng CC, Ho CY, Levin SK, Illner P. Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth. 2004;18(5):552-558.
8. Weiss AJ, Elixhauser A, Andrews RM. Characteristics of Operating Room Procedures in U.S. Hospitals, 2011: Statistical Brief #170. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014.
9. Based on internal Medtronic white paper #11-PM-0232(1), Cerebral oximetry is frequently a “first alert” indicator of adverse outcomes. April 2016.
10. Anastasiadis K, Antonitsis P, Deliopoulos A, Argiriadou H. A multidisciplinary perioperative strategy for attaining "more physiologic" cardiac surgery. Perfusion. 2017;32(6):446-453.
11. Goldman S, Sutter F, Ferdinand F, Trace C. Optimizing intraoperative cerebral oxygen delivery using noninvasive cerebral oximetry decreases the incidence of stroke for cardiac surgical patients. Heart Surg Forum. 2004;7(5):E376-381.