Role of Near infrared spectroscopy monitoring in intra-operative period for neurological outcomes in Complex aortic surgeries- A study of 50 adult cases.

Articles in Press

Document Type : Original Article

Authors

1 U. N. Mehta Institute of Cardiology and Research Centre

2 SV College, Tirupati, Andhra Pradesh

10.22038/jctm.2026.94583.1525

Abstract

Introduction

Complex aortic surgeries are associated with a considerable risk of perioperative neurological complications, mainly due to cerebral hypoperfusion, ischemia, or embolic events. Early recognition of cerebral oxygen imbalance during surgery may help in reducing postoperative neurological morbidity. Near-infrared spectroscopy (NIRS) offers a non-invasive method for continuous monitoring of regional cerebral oxygen saturation (rSO₂).

Methods

This observational study included 50 adult patients undergoing complex aortic surgery. Baseline cerebral rSO₂ values were recorded using NIRS before induction and monitored throughout the intraoperative period. Cognitive function was assessed using the Standard Mini-Mental State Examination (SMMSE) before surgery and again in the postoperative period. Intraoperative changes in NIRS values were compared with postoperative Standard Mini-Mental State Examination (SMMSE) scores to evaluate cognitive decline and delirium. Additional clinical outcomes, including duration of mechanical ventilation and length of intensive care unit stay, were also analysed.

Results

A fall in intraoperative cerebral rSO₂ was associated with a reduction in postoperative Standard Mini-Mental State Examination (SMMSE) scores, indicating postoperative cognitive decline in a subset of patients. Patients with lower intraoperative NIRS values also showed a tendency toward prolonged ventilation and longer ICU stay. Postoperative cognitive dysfunction was observed in approximately 10% of the study population.

Conclusion

Intraoperative NIRS monitoring may be a useful adjunct in complex aortic surgeries for detecting cerebral desaturation and identifying patients at risk of postoperative cognitive dysfunction. Reduced rSO₂ values were associated with poorer neurological recovery, prolonged ventilation, and increased ICU stay.

Keywords

Journal of Cardio-Thoracic Medicine

Articles in Press, Accepted Manuscript
Available Online from 20 June 2026

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