RT info:eu-repo/semantics/article
T1 Near-infrared spectroscopy monitoring in cardiac and noncardiac surgery: Pairwise and network meta-analyses
A1 Ortega Loubon, Christian Joseph
A1 Herrera Gómez, Francisco Magno
A1 Bernuy Guevara, Coralina Melissa
A1 Jorge Monjas, Pablo
A1 Ochoa Sangrador, Carlos
A1 Bustamante Munguira, Juan
A1 Tamayo Gómez, Eduardo
A1 Álvarez González, Francisco Javier
K1 Spectroscopy
K1 Espectroscopia
K1 3213.07 Cirugía del Corazón
AB 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.
PB MDPI
SN 2077-0383
YR 2019
FD 2019
LK https://uvadoc.uva.es/handle/10324/52794
UL https://uvadoc.uva.es/handle/10324/52794
LA eng
NO Journal of Clinical Medicine, 2019, vol. 8, n. 12, 2208
NO Producción Científica
DS UVaDOC
RD 22-nov-2024