Avoid hypotension and hypoxia: an old anesthetic adage with renewed relevance from cerebral oximetry monitoring

Excerpt

In this freestanding editorial, issues are discussed regarding advancements in patient monitoring modalities and how they are poised to continue the evolution of perioperative management. Innovations in cerebral oximetry technologies using near infrared spectroscopy (NIRS) is utilized may allow us to reconsider how we define and manage both hypotension and hypoxemia. With the exception of cardiac anesthesia where cerebral oximetry had early (though arguably still sporadic) clinical adoption, its dispersion into other perioperative disciplines has been somewhat limited. However, the information this technology provides could significantly alter how we manage many physiologic perturbations seen during anesthesia. As a corollary to the scrutiny directed at pulse oximetry when it first came into clinical practice, cerebral oximetry is on the precipice of an increasingly steeper adoption curve which demands a similar evaluation of its uses and potential efficacy. The purpose of this editorial is to discuss how the use of NIRS cerebral oximetry may require clinicians to re-examine their understanding of perioperative physiologic management, particularly that related to blood pressure and oxygenation. …