Cerebral perfusion and metabolic neuromonitoring during cardiopulmonary bypass

During surgery with cardiopulmonary bypass (CPB), maintaining adequate cerebral blood flow (CBF) is paramount to prevent adverse neurological outcome; tissue damage can occur if CBF reduction is sufficient to impair energy metabolism. Ten adult patients undergoing cardiothoracic surgery with CPB received perfusion and metabolic neuromonitoring using a novel optical system combining diffuse correlation spectroscopy and broadband near-infrared spectroscopy. CPB onset resulted in large increases in CBF and significant drops in mean arterial pressure and metabolism. No changes were observed transitioning off CPB. Real-time assessment of cerebral perfusion and metabolism could alert clinicians to relevant hemodynamic events before brain injury occurs.