Perioperative medicine & outcomes
Use of near infrared spectroscopy for the prediction of perioperative complications in patients undergoing elective microsurgical resection of cerebral arteriovenous malformations- a prospective observational trial (NIRSCAM trial)
Authors' conclusion
In patients undergoing cerebral AVM resection, a post-resection ipsilateral rScO2 increase by > 12% with a drift ratio of > 1.3 could signify cerebral hyperemia. A postoperative ipsilateral rScO2 drift > 14.5% with a drift ratio of 2.1 from the baseline is associated with postoperative complications in our study.
Study context
- Population
- Patients undergoing elective supratentorial cerebral arteriovenous malformations (AVM) resection
- Participants
- 25 patients
- Exposure
- Patients with vs without postoperative complications
- Group Bn = 9
- Outcome
- Ipsilateral rScO2 (NIRS)
Methodological detailsrScO2 drift > 12% from baseline managed per study protocol; monitoring continued 12 h postoperatively
- rScO2 drift > 12% from baseline managed per study protocol; monitoring continued 12 h postoperatively
Further findings
Mean ipsilateral rScO2 drift N2–N5 (post excision)
P = 0.02
Mean ipsilateral rScO2 drift N1–N6 (postoperatively)
P < 0.01
Mean
| Outcome | Group A | Group B | P value |
|---|---|---|---|
| Ipsilateral mean rScO2 at time of complication (Pc) | 70.52 (SD 7.17) | 62.08 (SD 9.33) | P = 0.04 |
| Mean ipsilateral rScO2 drift ratio (N5:N2) | 1.01 (SD 0.06) | 1.32 (SD 0.01) | P < 0.001 |
| Ipsilateral mean rScO2, immediate post excision | 73.52 (SD 7.07) | 83.03 (SD 6.08) | P < 0.01 |
| Mean ipsilateral rScO2 drift ratio (N6:N1) | 1.05 (SD 0.03) | 2.17 (SD 0.02) | P < 0.0001 |
- Mean ipsilateral rScO2 drift ratio (N6:N1): abstract text states "significantly lower in group B" despite higher values
Original publication
Use of near infrared spectroscopy for the prediction of perioperative complications in patients undergoing elective microsurgical resection of cerebral arteriovenous malformations- a prospective observational trial (NIRSCAM trial). J Clin Monit Comput. Published 2 November 2023. doi:10.
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