title: Cerebral perfusion monitoring in acute care surgery: current and perspective use.
abstract: BACKGROUND
  The technology near infrared spectroscopy (NIRS) has been utilized extensively in several clinical settings and one of which is in cerebral oximetry. This review will provide information on the technology, clinical applications and algorithm to follow when desaturation occurs.
  
  
  METHODS
  The review will cover the technology of near infrared spectroscopy, cerebral oximetry and the utilization of cerebral oximetry in each clinical setting. Expert commentary: Cerebral oximetry provides a noninvasive measure of cerebral oxygenation, which when persistently declining, can serve as a warning sign of hemodynamic or metabolic compromise intraoperatively or a predictor of postoperative cognitive dysfunction. Although useful, the cerebral oximetry readings must be interpreted in the context of other clinical information. When cerebral desaturation is confirmed, an algorithm should be followed in an attempt to increase oxygen delivery to the brain and/or decrease cerebral metabolic rate of oxygen.
authors.affiliation: a Department of Anesthesiology , Chang Gung Memorial Hospital , Taoyuan , Taiwan.|b College of Medicine , Chang Gung University , Taoyuan , Taiwan.|d Graduate Institute of Clinical Medical Sciences , Chang Gung University , Taoyuan , Taiwan.
authors.forename: Hsin-I
authors.initials: HI
authors.lastname: Tsai
authors.affiliation: a Department of Anesthesiology , Chang Gung Memorial Hospital , Taoyuan , Taiwan.|b College of Medicine , Chang Gung University , Taoyuan , Taiwan.
authors.forename: Peter Chi-Ho
authors.initials: PC
authors.lastname: Chung
authors.affiliation: b College of Medicine , Chang Gung University , Taoyuan , Taiwan.|c Department of Surgery , Chang Gung Memorial Hospital , Taoyuan , Taiwan.
authors.forename: Chao-Wei
authors.initials: CW
authors.lastname: Lee
authors.affiliation: a Department of Anesthesiology , Chang Gung Memorial Hospital , Taoyuan , Taiwan.|b College of Medicine , Chang Gung University , Taoyuan , Taiwan.
authors.forename: Huang-Ping
authors.initials: HP
authors.lastname: Yu
mesh_terms: D000465:Algorithms; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003422:Critical Care / Q000379:methods*; D006801:Humans; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D010092:Oximetry; D010477:Perfusion / Q000379:methods*
keywords: Near-infrared spectroscopy; acute care surgery; cerebral oxygenation; monitoring