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. 2024 Jun 18:11:1404210.
doi: 10.3389/fcvm.2024.1404210. eCollection 2024.

Effect of near-infrared spectroscopy on postoperative delirium in cardiac surgery with cardiopulmonary bypass: a systematic review and meta-analysis

Qian Sun  1 , Weiguo Wu  1
Affiliations

Effect of near-infrared spectroscopy on postoperative delirium in cardiac surgery with cardiopulmonary bypass: a systematic review and meta-analysis

Qian Sun et al. Front Cardiovasc Med. .

Abstract

Background: Postoperative delirium (POD) is a common anesthetic side effect in cardiac surgery. However, the role of oxygen saturation monitoring in reducing postoperative delirium has been controversial. Therefore, this meta-analysis aimed to analyze whether NIRS monitoring during cardiac surgery under cardiopulmonary bypass could reduce the incidence of postoperative delirium.

Methods: PubMed, Web of Science, Cochrane Library, Embase and China National Knowledge Infrastructure (CNKI) databases were systematically searched using the related keywords for randomized-controlled trials (RCTs) published from their inception to March 16, 2024. This review was conducted by the Preferred Reporting Project and Meta-Analysis Statement (PRISMA) guidelines for systematic review. The primary outcome was postoperative delirium, and the second outcomes included the length of ICU stay, the incidence of kidney-related adverse outcomes, and the incidence of cardiac-related adverse outcomes.

Results: The incidence of postoperative delirium could be reduced under the guidance of near-infrared spectroscopy monitoring (OR, 0.657; 95% CI, 0.447-0.965; P = 0.032; I2 = 0%). However, there were no significant differences in the length of ICU stay (SMD, 0.005 days; 95% CI, -0.135-0.146; P = 0.940; I2 = 39.3%), the incidence of kidney-related adverse outcomes (OR, 0.761; 95% CI, 0.386-1.500; P = 0.430; I2 = 0%), and the incidence of the cardiac-related adverse outcomes (OR, 1.165; 95% CI, 0.556-2.442; P = 0.686; I2 = 0%) between the two groups.

Conclusion: Near-infrared spectroscopy monitoring in cardiac surgery with cardiopulmonary bypass helps reduce postoperative delirium in patients.

Systematic review registration: PROSPERO, identifier, CRD42023482675.

Keywords: cardiac surgery; cardiopulmonary bypass; cerebral oxygen saturation; meta-analysis; near-infrared spectroscopy; postoperative delirium.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study selection process.
Figure 2
Figure 2
Risk of bias summary.
Figure 3
Figure 3
Risk of bias graph of each study.
Figure 4
Figure 4
Forest plot of the effect of near-infrared spectroscopy on postoperative delirium in patients undergoing cardiac surgery with cardiopulmonary bypass.
Figure 5
Figure 5
(A) Forest plot of the effect of near-infrared spectroscopy on ICU stay in patients undergoing cardiac surgery with cardiopulmonary bypass. (B) Forest plot of the effect of near-infrared spectroscopy on the incidence of kidney-related adverse outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass. (C) Forest plot of the effect of near-infrared spectroscopy on cardiac-related adverse outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass.
Figure 6
Figure 6
Subgroup analysis according to the different intervention premises.
See this image and copyright information in PMC

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