Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

Role of Near Infrared Spectroscopy Monitoring in Intra-Operative Period for Neurological Outcomes in Complex Aortic Surgeries- A study of 50 Adult Cases

Document Type : Original Article

Authors
Mittapalli Jeevan Babu 1
Rajeshkumar M Thosani 1
Kaushal Patel 1
Guriqbal Singh 1
Jigar Patel 1
Chirag Doshi 2
Hima Bindu 3
1 Department of Cardiac Anesthesiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India.
2 Department of CVTS, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India.
3 SV College, Tirupati, Andhra Pradesh, 517502, India.
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 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 analyzed.
Results: A fall in intraoperative cerebral rSO₂ was associated with a reduction in postoperative 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 intensive care unit (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
Aortic Aneurysm
Cognitive Dysfunction
Intraoperative Monitoring
Ischemia
Near-Infrared
Spectroscopy
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Journal of Cardio-Thoracic Medicine
Volume 14, Issue 2
Spring 2026
Pages 1676-1682