Near-infrared spectroscopy for monitoring cerebral oxygenation in neurosurgical and critical care settings

Near-infrared spectroscopy (NIRS) has emerged as a valuable non-invasive tool for monitoring cerebral oxygenation in neurosurgical and critical care settings. Maintaining adequate cerebral oxygenation is crucial to prevent irreversible brain injury and mortality. Traditional methods like intracranial pressure and cerebral perfusion pressure monitoring do not directly reflect cerebral blood flow or oxygen saturation. Invasive techniques such as jugular venous oxygen saturation and brain tissue partial pressure of oxygen monitoring have limitations in reflecting regional changes and carry inherent risks. This manuscript explores the application of NIRS technology for continuous and non-invasive assessment of cerebral oxygenation. NIRS utilizes near-infrared light to penetrate the skull and measure changes in oxygenated and deoxygenated hemoglobin concentrations in the brain tissue. This allows for real-time monitoring of cerebral oxygen saturation, providing valuable insights into the balance between oxygen supply and demand. The benefits of NIRS include its non-invasiveness, portability, continuous monitoring capability, and potential for detecting regional cerebral ischemia. This review discusses the principles of NIRS, its application in various neurosurgical procedures and critical care scenarios, and its potential to improve patient outcomes by enabling timely interventions to maintain optimal cerebral oxygenation.