Poor oxygenation can cause poor patient outcomes, even when the operation itself seemed to go smoothly. The INVOS® Cerebral/Somatic Oximeter noninvasively identifies threats to cerebral and somatic oxygenation stemming from mechanical and/or physiological causes. That’s why 51% of the approximately 1,000 hospitals performing adult cardiac procedures in the United States have INVOS technology available. This includes two-thirds of the Top 50 adult heart and heart surgery hospitals as ranked by US News & World Report.
Cerebral oximetry first gained broad acceptance in the adult cardiac surgery arena and for good reason. The procedures are highly complex and today's cardiac surgery patients are becoming older, sicker and more challenging than in the past.
The INVOS
® System makes a meaningful, positive impact on performance measures and clinical outcomes despite these complexities. Among other benefits, studies have shown that the INVOS
® System can help to reduce:
- Major organ morbidity or mortality (MOMM)1
- Stroke2
- Post-op cognitive declines3
- Respiratory failure/prolonged vent time2
- Adverse surgical events4
- Coma5
Continue Protection in the ICU
The post-op period remains a time of compromise and potential complications for patients. Cerebral monitoring is encouraged during this time until the patient's hemodynamics are stable. Studies show that cerebral oxygen desaturation has been associated with a prolonged intensive care unit stay and hospital length of stay.
1,6
Limiting cerebral/somatic oximetry to the OR may limit visibility of ischemia in the ICU. Each stage is critical. Using the INVOS
® System will help you and your team continue to provide an outstanding level of care to your patients. Here is a sample of the types of issues and challenges that can affect cerebral oxygenation:
- Malfunctions in equipment can and do occur. Some may cause respiratory or hemodynamic problems, resulting in unwanted disturbances in the patient's perfusion status. By detecting problematic oxygen levels, the INVOS® System has helped reveal a host of mechanical malfunctions such as ventilator disconnects, ETT dislodgments, disconnect of intravenous lines carrying inotropes, or support devices with insufficient battery back up (Data on file).
- In some instances, traditional metrics such as pulse oximetry and blood pressure have not demonstrated to be a reliable detector of regional tissue hypoxia, whereas the INVOS® System has. This is largely because they are systemic metrics rather than site-specific like the INVOS® System.
- Certain drugs or dosages may diminish cardiac output causing inadequate oxygen delivery and the patient's rSO2 levels to desaturate. Even an inadequate amount of sedative can increase cerebral metabolic demands, causing rSO2 to decline.
- Similarly, continued somatic monitoring in the ICU may be extremely valuable, especially following cases that involve femoral cannulation, peripheral vascular repair and intra aortic balloon placement. Monitoring in these cases helps confirm proper lower extremity perfusion to identify oxygen deficiencies consistent with complications such as compartment syndrome.
Footnotes:
1. Murkin JM, et al. Anesth Analg 2007; 104:51-8.
2. Goldman S, et al. Heart Surg Forum. 2004;7(5):E376-81.
3. Casati A, et al., Anesth & Analg 2005;101:740.
4. Gottlieb EA, et al. Ped Anesth 2006; 16:787-9.
5. Ganzel BL, et al. Presented at the STS Annual Meeting, Jan 2002, Ft. Lauderdale, FL.
6. Iglesias I, Murkin JM, Bainbridge D, Adams S. Presented at Outcomes 2003,
May 22, 2003, Key West.
