The effectiveness of cerebral oximetry during coronary artery bypass: a systematic review protocol.

Abstract

REVIEW QUESTION / OBJECTIVE The objective is to identify the effectiveness of cerebral oximetry monitoring in reducing the incidence of perioperative stroke in patients undergoing coronary artery bypass. INCLUSION CRITERIA Types of participants This review will consider studies that include human subjects, aged 18 years and older, undergoing coronary artery bypass surgery; therefore patients 17 years and younger will be excluded from this study. Our exclusion of pediatric patients is due to the variability in cardiac pathology presentation and the various etiologies of cardiac complications in children, which are not similar to those in the adult cardiac population. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate cerebral oximetry monitoring in comparison to absence of cerebral oximetry monitoring. When cerebral oximetry was utilized in intervention groups, desaturation guidelines were individually established to guide treatment. Desaturation was defined differently between studies; however, regardless of varying guidelines, steps were taken to correct saturations back to established baselines set by the individual study. Types of outcomes This review will consider studies that include the following outcome measures: the incidence of perioperative stroke (i.e. from the surgical period to end of hospitalization), defined as brain, spinal cord, or retinal cell death attributable to ischemia, based on neuropathological, neuroimaging and/or clinical evidence of injury.