CRITICAL-EVALUATION OF NONINVASIVE OXYGEN MONITORING

Recently, professional anaesthesiologists organizations, have set up r ecommendations for intraoperative monitoring. These recommendations ar e based upon the assumption that anaesthesia-related deaths are largel y preventable and that extensive monitoring will reduce mortality. Hyp oxaemia appears to be an important pathophysiological mechanism, and t his is why oxygen monitoring is given a high priority in safety standa rds in anaesthesia. However, no reduction in mortality has been defini tively shown to follow the use of any monitoring device in randomized, controlled trials. Four techniques of oxygen monitoring are discussed and evaluated. Oxygen monitoring during inspiration can be recommende d? although its implementation will probably prevent only a few anaest hesia-related deaths. Pulse oximetry is certainly highly recommended, but also has some deficiencies which are not sufficiently well known c onsidering the popularity of this technique. Transcutaneous PO2 is con sidered mainly for historical reasons. Near infrared spectrometry is a new technique offering noninvasive and continuous monitoring of intra cerebral oxygenation.