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Cerebral Near-Infrared Spectroscopy in Adults: A Work in Progress

Ghosh, Arnab MBChB, BSc (Hons), MRCS*; Elwell, Clare PhD; Smith, Martin MBBS, FRCA, FFICM†‡

doi: 10.1213/ANE.0b013e31826dd6a6
Neuroscience in Anesthesiology and Perioperative Medicine: Review Article
Continuing Medical Education

Near-infrared spectroscopy (NIRS) has potential as a noninvasive brain monitor across a spectrum of disorders. In the last decade, there has been a rapid expansion of clinical experience using NIRS to monitor cerebral oxygenation, and there is some evidence that NIRS-guided brain protection protocols might lead to a reduction in perioperative neurologic complications after cardiac surgery. However, there are no data to support the wider application of NIRS during routine surgery under general anesthesia, and its application in brain injury, where it might be expected to have a key monitoring role, is undefined. Although increasingly sophisticated apparatuses, including broadband and time-resolved spectroscopy systems, provide insights into the potential of NIRS to measure regional cerebral oxygenation, hemodynamics, and metabolism in real-time, these innovations have yet to translate into effective monitor-guided brain protection treatment strategies. NIRS has many potential advantages over other neuromonitoring techniques, but further investigation and technological advances are necessary before it can be introduced more widely into clinical practice.

Published ahead of print November 9, 2012

From the *Department of Neurocritical Care, Institute of Neurology, University College London; Department of Medical Physics and Bioengineering, University College London; and Department of Neurocritical Care, University College London Hospitals, London, United Kingdom.

Published ahead of print November 9, 2012

Supported by MRC Clinical Research Training Fellowship G1000292 (to AG), and partially supported by the Department of Health’s Institute for Health Research Centre’s funding scheme via the UCLH/UCL Biomedical Research Centre (to MS).

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Martin Smith, MBBS, FRCA, FFICM, Department of Neurocritical Care, Box 30, The National Hospital for Neurology and Neurosurgery, University College London Hospitals, Queen Square, London WC1N 3BGUK. Address e-mail to martin.smith@uclh.nhs.uk.

© 2012 International Anesthesia Research Society