University of Oulu

Lanning, KM, Ylikauma, LA, Erkinaro, TM, Ohtonen, PP, Vakkala, MA, Kaakinen, TI. Changes in transcranial near-infrared spectroscopy values reflect changes in cardiac index during cardiac surgery. Acta Anaesthesiol Scand. 2023; 67(5): 599-605. doi:10.1111/aas.14210

Changes in transcranial near-infrared spectroscopy values reflect changes in cardiac index during cardiac surgery

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Author: Lanning, Katriina M.1; Ylikauma, Laura A.1; Erkinaro, Tiina M.1;
Organizations: 1Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
2Research Service Unit, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: John Wiley & Sons, 2023
Publish Date: 2023-09-13


To determine whether changes in transcranial near-infrared spectroscopy (NIRS) values reflect changes in cardiac index (CI) in adult cardiac surgical patients. Single-center prospective post hoc analysis. University hospital. One hundred and twenty-four adult patients undergoing cardiac surgery. In each patient, several CI measurements were taken, and NIRS values were collected simultaneously. We used a hierarchical linear regression model to assess the association between NIRS values and CI. We calculated a crude model with NIRS as the only factor included, and an adjusted model, where mean arterial pressure, end-tidal CO₂, and oxygen saturation were used as confounding factors. A total of 1301 pairs of NIRS and CI values were collected. The analysis of separate NIRS and CI pairs revealed a poor association, which was not statistically significant when adjusted with the chosen confounders. However, when the changes in NIRS from baseline or from the previous measurement were compared to those of CI, a clinically and statistically significant association between NIRS and CI was observed also in the adjusted model. Compared to the baseline and to the previous measurement, respectively, the regression coefficients with 95% confidence intervals were 0.048 (0.041–0.056) and 0.064 (0.055–0.073) in off-pump coronary artery bypass patients and 0.022 (0.016–0.029) and 0.026 (0.020–0.033) in patients who underwent cardiopulmonary bypass. In an unselected cardiac surgical population, the changes in NIRS values reflect those in CI, especially in off-pump coronary artery bypass patients. In this single-center post hoc analysis of data from a prospectively collected database of cardiac surgery patients, paired measurements of cardiac output and NIRS revealed that while there was a no correlation between individual paired measurements, a small correlation was found in changes in the two measurements from baseline values. This highlights a potential to utilize changes in NIRS from baseline to suggest changes in cardiac output in cardiac surgical populations.

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Series: Acta anaesthesiologica Scandinavica
ISSN: 0001-5172
ISSN-E: 1399-6576
ISSN-L: 0001-5172
Volume: 67
Issue: 5
Pages: 599 - 605
DOI: 10.1111/aas.14210
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
Funding: Financial support was provided from the sources of the Oulu University Hospital. No external funding was received. The authors declare no competing interests.
Copyright information: © 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.