Crafting Effective Abstracts- A Guide to Summarizing Research
Impact Statement
This study improves CRNAs’ intraoperative monitoring practices by justifying the importance of cerebral oximetry in cerebral oxygenation monitoring during and after the administration of anesthesia.
Background/Purpose/Question
CRNAs administer anesthesia and care for and monitor patients who have received anesthesia. Notably, the risk of developing cognitive dysfunction, especially among older patients after surgery, remains high. Regardless, evidence on whether the use of intraoperative cerebral oximetry monitoring ensures optimal regional cerebral oxygen saturation (rSO2) and reduces the risk of postoperative neurological complications in CRNA practice remains uncertain. This systematic review aims to comprehensively synthesize current literature examining intraoperative monitoring of cerebral oximetry to determine its significance in ensuring adequate intraoperative rSO2 and in preventing postoperative neurological complications. It is hypothesized that intraoperative monitoring of cerebral oximetry ensures optimal intraoperative rSO2 and better cognitive outcomes.
Methods/Evidence Search
A systematic review was employed to synthesize randomized controlled trials, prospective and retrospective cohort studies related to or investigating the use of cerebral oximetry in cardiac surgery, monitoring and managing cerebral oxygenation during and after surgery, and the relationship between cerebral oximetry monitoring with intraoperative cerebral oxygenation levels, and postoperative cognitive outcomes. Database searches were conducted in PubMed Central and ProQuest Central using keywords and phrases including cerebral oximetry monitoring, intraoperative monitoring, and cerebral and brain oximetry. The search was limited to articles published within the last five years. The screening of the studies, including their methodological quality and other characteristics, the selection of the studies for inclusion, and the extraction of the significant findings were guided by the PRISMA Checklist. Quantitative analysis methods were utilized to synthesize findings from eligible studies and identify trends in intraoperative monitoring of cerebral oximetry.
Synthesis of Literature/Results/Discussion
Six studies were identified and included in the review. Soh et al. 1, exploring the role of preoperative transcranial Doppler and cerebral oximetry in predicting delirium in patients after valvular heart surgery, reported that low preoperative rSO2 of less than 60% predicted the development of cognitive complications, specifically delirium in patients’ especially elderly patients after valvular heart surgery. In a related study, Lim et al. 2 argued that off-pump coronary artery bypass graft surgery (OPCAB) increased the risk of low rSO2 and delirium with the occurrence of delirium based on the duration of the low rSO2 (<45%). Additionally, Russo et al.3 found that cerebral oximetry monitoring strongly predicted the occurrence of cerebral ischemia and the related absolute rSO2 value. Three studies have explored the application of cerebral oximetry monitoring in optimizing oxygenation during surgery. Uysal et al.4 argue that performing intraoperative cerebral oximetry monitoring as a targeted therapy significantly optimizes cerebral oxygenation and improves memory outcomes in cardiac surgeries. Similarly, Juliana et al.5 argue that most complications in cardiac surgeries occur during surgery rather than post-surgery, with evidence supporting the use of intraoperative cerebral oximetry monitoring with reduced risk of cognitive dysfunction and rSO2-related complications 5,6.
Conclusion/Recommendations for Practice
The reviewed literature demonstrates that rSO2 desaturation, which is common during and after cardiac surgery, increases the risk of cognitive and other related complications. However, the majority of the complications due to rSO2 desaturation occur intraoperatively than during post-surgery 5 The evidence availed by the current study suggests that intraoperative cerebral oximetry monitoring as an intervention can significantly lower the risk of postoperative neurocognitive complications, including delirium, cognitive decline, and organ failures. The evidence from this review highlights the significance of intraoperative cerebral monitoring during surgeries, especially cardiothoracic surgeries, in preventing intraoperative rSO2 desaturation and perioperative and postoperative complications. It is recommended that CRNAs be engaged in related research to further applications of cerebral oximetry monitoring and related technologies in surgical patients’ monitoring as an intervention to mitigate perioperative complications in at-risk patients.
Conflict of Interest
The author declares that this systematic review did not receive commercial or financial support, which could lead to a potential conflict of interest.
References
Soh S, Shim JK, Song JW, Choi N, Kwak YL. Preoperative transcranial Doppler and cerebral oximetry as predictors of delirium following valvular heart surgery: a case-control study. J Clin Monit Comput. 2020;34(4):715-723. doi:10.1007/S10877-019-00385-X/FIGURES/3
Lim L, Nam K, Lee S, et al. The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study. BMC Anesthesiol. 2020;20(1):1-10. doi:10.1186/S12871-020-01180-X/TABLES/5
Russo MF, Gentile P, Fenga M, et al. Cerebral oximetry monitoring by means of INVOS-4100 as a predictor of ischemic events during carotid endarterectomy. Front Surg. 2023;10. doi:10.3389/FSURG.2023.1170019
Uysal S, Lin HM, Trinh M, Park CH, Reich DL. Optimizing cerebral oxygenation in cardiac surgery: A randomized controlled trial examining neurocognitive and perioperative outcomes. Journal of Thoracic and Cardiovascular Surgery. 2020;159(3). doi:10.1016/j.jtcvs.2019.03.036
Juliana N, Yazit NAA, Kadiman S, et al. Intraoperative cerebral oximetry in open heart surgeries reduced postoperative complications: A retrospective study. PLoS One. 2021;16(5):e0251157. doi:10.1371/JOURNAL.PONE.0251157
Wong ZZ, Chiong XH, Chaw SH, et al. The Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. 2022;36(7):2002-2011. doi:10.1053/
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An abstract is a concise, self-contained summary of a research paper. The abstract is meant to “preview” the larger body of work. This helps readers, and researchers find what they’re looking for and understand the magnitude of what is being discussed.
Crafting Effective Abstracts- A Guide to Summarizing Research
Attached you will find the rubric and the 15 correspondent to 15 articles, all related to the topic: Intraoperative Monitoring of Cerebral Oximetry
The abstract should possess the following sections and satisfy the corresponding criteria:
Title
• Clear, concise, direct
Impact Statement
• 200 characters, Not Words, (including spaces) or less
• How the study/abstract will impact or potentially impact the care that CRNAs deliver
Background/Purpose/Question
• 875 characters, Not Words, (including spaces) or less
• Define the nature and significance of the problem
• Clearly state the purpose of your project
• Clearly stated question your project addresses
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