Significance of Cerebral Oximeter in Surgeries

The cerebral oximeters is also known as regional oximeters or tissue oximeters obtain continuous cerebral oxygenation values using near-infrared spectroscopy (NIRS) technology based on the Beer-Lambert’s law. Cerebral oximeter consists of an oximeter probe (sensor) attached to a monitor, most cerebral oximeters can support single to multiple wavelengths with respective monitor cables. Accuracy is improved by using more wavelengths, more source-detector separations.

Cerebral oximeters are used in operation theaters during surgeries and the oximeter sensors can be placed anywhere on the head but most commonly it is placed on the forehead because there is the least amount of hair. The advantages of cerebral oximeters include non-invasiveness, it provides real-time data to the clinician at the bedside for immediate care decisions and observation of the effects of interventions and cerebral oximeters provides continuous information.

Due to the complications such as stroke and other adverse clinical effects of the surgeries, the monitoring of oxygen saturation level in the cerebra is needed. Cerebral oximetric monitoring serves as an early warning of decreased oxygen delivery to the brain and other major organs. These estimates of regional cerebral oximetry may be used to reverse decreasing cerebral perfusion and avert prolonged ischemia of the brain and other major organs by instituting a strategy that optimizes factors that affect cerebral oxygen supply and demand. Common surgeries that need monitoring of oxygen are cardiac surgery, vascular surgery and general surgery, increase in the number of surgeries are the main reason for the companies to offer more innovative cerebral oximeter in the market.

According to the American College of Cardiology (ACC), coronary artery bypass graft (CABG) is the most common open-heart surgery in the United States. About 395,000 people have this operation every year, angioplasty also referred to as PCI (percutaneous coronary intervention), a procedure to open coronary arteries clogged with plaque. These are the arteries that supply blood to the heart muscle, about 500,000 PCI procedures are done every year. During these cardiac surgeries, the supply of oxygen to the brain will vary, low oxygen saturation leads to cardiopulmonary cause and diagnostic dilemma, the decrease of intraoperative cerebral oxygen saturation to less than 80% of the preoperative baseline or to absolute levels lower than 50% have been associated with postoperative cognitive dysfunction, higher rate of stroke or coma increased postoperative morbidity from other non-neurological causes, and a prolonged stay in the high-dependency unit or the hospital, in order to overcome these complications continuous monitoring of oxygen saturation is required.

It is estimated that in Peripheral vascular surgery procedures performed worldwide is approximately 4.0 million and expected to reach 4.5 million by 2022. Patients with peripheral vascular disease undergoing vascular surgery under general anesthesia are monitored using cerebral and pulse oximeter. Poor peripheral perfusion and peripheral capillary oxygen saturation (SpO2) measurement is regular care for continuous analysis of blood oxygen saturation in these patients.

According to IQ4I analysis, globally, there are an estimated 463,605 operation theaters for approximately 7.5 billion populations, it is estimated that each operation theater requires at least one cerebral oximeter, however, the penetration of cerebral oximeter monitors has reached only 5.2% of the market globally and still, there is scope to reach 94.8% of the market. Since the awareness about the device is increasing the demand for cerebral oximeter also increasing, hence the companies in this market are implementing some strategies such as acquisition and new product approvals. For instance, in April 2019, Edwards Lifesciences Corporation acquired CAS Medical Systems, Inc. (CASMED), a medical technology company dedicated to non-invasive brain and tissue oxygenation monitoring. As part of the acquisition, Edwards acquired CASMED’s FORE-SIGHT non-invasive cerebral oxygenation technology. On the other hand, in June 2019, Masimo corporation received FDA clearance for its O3 Regional Oximetry for use in neonatal and infant patients (<10 kg). O3 may help clinicians monitor cerebral oxygenation in situations in which peripheral pulse oximetry alone may not be fully indicative of the oxygen in the brain. With this expansion of the O3 platform, the benefits of monitoring with O3 are now available to patients of all ages, from neonates to adults.

According to IQ4I analysis the cerebral oximeter the market is expected to grow at a CAGR of 5.0% from 2019 to 2026 to reach 179.1 million by 2026. Major players offering cerebral oximeter market are Major players of this market includes Medtronic PLC (Ireland), Spectros Corporation (U.S.), Mespere Lifesciences (Canada), Nonin Medical Inc. (U.S.), ViOptix Inc. (U.S.), Masimo Corporation (Switzerland) and Edwards Lifesciences Corporation (U.S.).

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