Cerebral near-infrared spectroscopy in the care of patients during cardiological procedures : a summary of the clinical evidence

Patients undergoing cardiological procedures generally have significant cardiovascular morbidity, and therefore these patients might be at risk for major periprocedural complications. The ability to closely monitor the hemodynamic status would present a major advantage to optimize patient care in this setting. The aim of this review is to assess the available evidence for the use of near-infrared spectroscopy (NIRS) in the care of patients during cardiological procedures. A systematic literature search was conducted using electronic bibliographic databases (MEDLINE, PubMed, EMBASE) from their first available date using the following search strategy: (spectroscopy, near-infrared OR infrared spectroscopy OR NIRS OR cerebral oxygen*) AND (interventional OR electrophysiological OR catheterization OR ablation OR ICD OR defibrillator). Inclusion criteria were limited to human studies, English language and cardiac patients. All manuscripts concerning the use of NIRS in every area of catheterization and electrophysiology were included. The literature search yielded eleven observational studies and five case reports concerning the research question. No randomized trials could be retrieved. Six studies evaluated NIRS during supraventricular and ventricular arrhythmias, one during transcatheter aortic valve implantations, and four studies assessed the use of NIRS in pediatric catheterization procedures. Overall, the studies demonstrated that NIRS provides a very quick representation of cerebral oxygen saturation and that it might identify changes that could not be predicted from standard hemodynamic monitoring. However, the evidence is currently too low to conclude that NIRS can optimize patient care during cardiological procedures