2026-05-05T18:36:52Zhttps://uvadoc.uva.es/oai/request

oai:uvadoc.uva.es:10324/527942024-12-18T08:37:47Zcom_10324_1138com_10324_931com_10324_894col_10324_1226

Ortega Loubon, Christian Joseph Herrera Gómez, Francisco Magno Bernuy Guevara, Coralina Melissa Jorge Monjas, Pablo Ochoa Sangrador, Carlos Bustamante Munguira, Juan Tamayo Gómez, Eduardo Álvarez González, Francisco Javier 2022-04-06T07:07:51Z 2022-04-06T07:07:51Z 2019 Journal of Clinical Medicine, 2019, vol. 8, n. 12, 2208 2077-0383 https://uvadoc.uva.es/handle/10324/52794 10.3390/jcm8122208 Producción Científica Goal-directed therapy based on brain-oxygen saturation (bSo2) is controversial and hotly debated. While meta-analyses of aggregated data have shown no clinical benefit for brain near-infrared spectroscopy (NIRS)-based interventions after cardiac surgery, no network meta-analyses involving both major cardiac and noncardiac procedures have yet been undertaken. Randomized controlled trials involving NIRS monitoring in both major cardiac and noncardiac surgery were included. Aggregate-level data summary estimates of critical outcomes (postoperative cognitive decline (POCD)/postoperative delirium (POD), acute kidney injury, cardiovascular events, bleeding/need for transfusion, and postoperative mortality) were obtained. NIRS was only associated with protection against POCD/POD in cardiac surgery patients (pooled odds ratio (OR)/95% confidence interval (CI)/I2/number of studies (n): 0.34/0.14–0.85/75%/7), although a favorable effect was observed in the analysis, including both cardiac and noncardiac procedures. However, the benefit of the use of NIRS monitoring was undetectable in Bayesian network meta-analysis, although maintaining bSo2 > 80% of the baseline appeared to have the most pronounced impact. Evidence was imprecise regarding acute kidney injury, cardiovascular events, bleeding/need for transfusion, and postoperative mortality. There is evidence that brain NIRS-based algorithms are effective in preventing POCD/POD in cardiac surgery, but not in major noncardiac surgery. However, the specific target bSo2 threshold has yet to be determined. Junta de Castilla y León (project VA161G18) application/pdf eng MDPI info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/4.0/ © 2019 The Authors Atribución 4.0 Internacional Spectroscopy Espectroscopia 3213.07 Cirugía del Corazón Near-infrared spectroscopy monitoring in cardiac and noncardiac surgery: Pairwise and network meta-analyses info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://www.mdpi.com/2077-0383/8/12/2208/htm SI