Researchers Harness the Power of Masimo Root’s Advanced Multimodal Monitoring Capabilities to Study the Impact of Different Ventilatory Strategies on Brain Oxygenation During Thoracoscopic Surgery

Masimo (NASDAQ: MASI) today announced the findings of a prospective, single-blinded, randomized controlled study published in the Journal of Anesthesia & Intensive Care Medicine in which Dr. Mona Mohamed Mogahed and colleagues at Tanta University in Tanta, Egypt and The King Fahd General Hospital in Jeddah, Saudi Arabia, sought to evaluate the impact of varying ventilation strategies on the cerebral oxygenation of patients undergoing video-assisted thoracoscopic surgery (VATS). To monitor the variety of physiological parameters needed to undertake such an evaluation, they turned to the multi-modal Masimo Root patient monitoring and connectivity platform, which is designed to allow clinicians to streamline their ability to keep track of numerous modalities, simultaneously, using a single, intuitive monitor. The technologies involved included O3 regional oximetry, capnography with NomoLine sampling lines, SedLine brain function monitoring, and multiple rainbow Pulse CO-Oximetry measurements. Using Root and Masimo monitoring technologies, the researchers were able to determine that maintaining higher end-tidal carbon dioxide (EtCO₂) improved baseline regional cerebral oxygenation (rSO₂), with impacts on early postoperative cognitive function that included improvements in Aldrete scores and mini mental status exam (MMSE) scores.¹

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Masimo Root (Graphic: Business Wire)

Noting the increased risk of hypoxemia during one-lung ventilation (OLV) as part of VATS, which can lead to postoperative neurocognitive dysfunctions, the authors hypothesized that increasing EtCO₂ could be a “convenient and powerful” way to manage cerebral desaturation during the surgery. They enrolled 70 patients, ages 18-65, undergoing elective VATS requiring OLV, between September 2021 and September 2022 at The King Fahd General Hospital, Jeddah. All patients were operated on by the same surgical team. The patients were randomly divided into two groups: in the first, EtCO₂ was maintained at 32-38 mmHg (group I) and in the second, at 39-45 mmHg (group II). During the procedure, monitored parameters included oxygen saturation (Masimo SET SpO₂), heart rate (HR), and noninvasive hemoglobin (Masimo SpHb) via an RD rainbow SET fingertip sensor; EtCO₂ via capnometer and NomoLine sampling line; noninvasive blood pressure (NIBP), body temperature, and rSO₂ via O3 near-infrared spectroscopy (NIRS) sensors monitoring both brain hemispheres; and Masimo Patient State Index (PSi), a processed EEG parameter used to help clinicians maintain appropriate sedation, via SedLine. Outcomes included Aldrete scores and MMSE scores assessed at 3 and 24 hours after surgery.