scholarly journals Near-infrared Spectroscopy Monitoring During Cardiac Arrest: A Systematic Review and Meta-analysis

2016 ◽  
Vol 23 (8) ◽  
pp. 851-862 ◽  
Author(s):  
Alexis Cournoyer ◽  
Massimiliano Iseppon ◽  
Jean-Marc Chauny ◽  
André Denault ◽  
Sylvie Cossette ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Meta Analysis

scholarly journals LO041: Predicting the return of spontaneous circulation using near-infrared spectroscopy monitoring: a systematic review and meta-analysis

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S44-S44
Author(s):  
A. Cournoyer ◽  
J. Chauny ◽  
M. Iseppon ◽  
A. Denault ◽  
S. Cossette ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Grey Literature ◽  
Case Series ◽  
Spontaneous Circulation ◽  
Mean Deviation ◽  
Return Of Spontaneous Circulation

Introduction: Tissue oximetry using near-infrared spectroscopy (NIRS) is a non-invasive monitor of cerebral oxygenation. This new technology has been used during cardiac arrest because of its ability to give measures in low blood flow situations. The aim of this systematic review was to assess the evidence regarding the association between NIRS values and resuscitation outcomes in patients undergoing cardiopulmonary resuscitation. We hypothesized that higher NIRS values would be associated with better outcomes and that the strength of that association would differ depending on the timing of the NIRS measurements. Methods: This review was registered (Prospero CRD42015017380) and is reported as per the PRISMA guidelines. Medline, Embase and CENTRAL were searched from their inception to September 18th, 2015 using a specifically designed search strategy. Grey literature was also searched using Web of Science and Google Scholar. NIRS manufacturers and authors of included citations were contacted to inquire on unpublished results. Finally, the references of all retained articles were reviewed in search of additional relevant studies. Studies reporting NIRS monitoring in adults during cardiac arrest were eligible for inclusion. Case reports and case series of fewer than five patients were automatically excluded. Two reviewers assessed the quality of included articles and extracted the data. Results: Out of 3275 unique citations, 19 non-randomized observational studies (15 articles and four conference abstracts) were included in this review, for a total of 2436 patients. Six studies were evaluated at low risk of bias, nine at intermediate risk and four at high risk. We found a stronger association between the return of spontaneous circulation (ROSC) and the highest NIRS value measured during resuscitation (standard mean deviation (SMD) 3.46 (95%CI 2.31-4.62)) than between ROSC and the mean NIRS measures (SMD 1.33 (95%CI 0.92-1.74)) which was superior to the one between ROSC and initial measures (SMD 0.45 (95%CI 0.02-0.88)). Conclusion: Patients with good outcomes have significantly higher NIRS value during resuscitation than their counterparts. The association between ROSC and NIRS measurements was influenced the timing of measurements during resuscitation.

scholarly journals Near-infrared spectroscopy (NIRS) to detect traumatic intracranial haematoma: A systematic review and meta-analysis

Brain Injury ◽  
2017 ◽  
Vol 31 (5) ◽  
pp. 581-588 ◽  
Author(s):  
Robert J. Brogan ◽  
Vassilios Kontojannis ◽  
Bhavin Garara ◽  
Hani J. Marcus ◽  
Mark H. Wilson
Keyword(s):  
Systematic Review ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Meta Analysis ◽  
Intracranial Haematoma

scholarly journals Effects of cerebral near-infrared spectroscopy on the outcome of patients undergoing cardiac surgery: a systematic review of randomised trials

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016613 ◽  
Author(s):  
Giuseppe Filiberto Serraino ◽  
Gavin J Murphy
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Infrared Spectroscopy ◽  
Resource Use ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Meta Analysis ◽  
Red Cell ◽  
Randomised Trials ◽  
Red Cell Transfusion

ObjectivesGoal-directed optimisation of cerebral oxygenation using near-infrared spectroscopy (NIRS) during cardiopulmonary bypass is widely used. We tested the hypotheses that the use of NIRS cerebral oximetry results in reductions in cerebral injury (neurocognitive function, serum biomarkers), injury to other organs including the heart and brain, transfusion rates, mortality and resource use.DesignSystematic review and meta-analysis.SettingTertiary cardiac surgery centres in North America, Europe and Asia.ParticipantsA search of Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature Plus from inception to November 2016 identified 10 randomised trials, enrolling a total of 1466 patients, all in adult cardiac surgery.InterventionsNIRS-based algorithms designed to optimise cerebral oxygenation versus standard care (non-NIRS-based) protocols in cardiac surgery patients during cardiopulmonary bypass.Outcome measuresMortality, organ injury affecting the brain, heart and kidneys, red cell transfusion and resource use.ResultsTwo of the 10 trials identified in the literature search were considered at low risk of bias. Random-effects meta-analysis demonstrated similar mortality (risk ratio (RR) 0.76, 95% CI 0.30 to 1.96), major morbidity including stroke (RR 1. 08, 95% CI 0.40 to 2.91), red cell transfusion and resource use in NIRS-treated patients and controls, with little or no heterogeneity. Grades of Recommendation, Assessment, Development and Evaluation of the quality of the evidence was low or very low for all of the outcomes assessed.ConclusionsThe results of this systematic review did not support the hypotheses that cerebral NIRS-based algorithms have clinical benefits in cardiac surgery.Trial registration numberPROSPERO CRD42015027696.

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