Should cerebral oximetry be employed in morbidly obese patients undergoing bariatric surgery?

Abstract

A 40-year-old morbidly obese male, body mass index (BMI) 60, with complications including obstructive sleep apnea, hyperlipidemia, hypertension, and type II diabetes mellitus, is undergoing Roux-en-Y gastric bypass weight loss surgery. He has a large neck circumference and a Mallampati score of 3. Difficult intubation is anticipated, so the plan is to proceed with fiberoptic laryngoscopy. A near-infrared spectrometry (NIRS) cerebral oximeter is placed on the patient’s forehead to monitor cerebral venous saturation (rScO2); his baseline is 73 %. Peripheral intravenous lines are placed under ultrasound guidance.