{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:28:25Z","timestamp":1787228905650,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Near-infrared spectroscopy-based cerebral oximetry is commonly used to detect cerebral hypoxia during anesthesia. However, the clinical significance of extremely low regional cerebral oxygen saturation (rSO\n                    <jats:sub>2<\/jats:sub>\n                    ) in noncardiac surgery in severe sepsis remains unclear. We report two patients with severe sepsis who underwent emergency noncardiac surgery under general anesthesia. In both cases, systemic parameters, including arterial blood pressure, arterial oxygen saturation, and bispectral index, were within clinically acceptable ranges. Nevertheless, intraoperative rSO\n                    <jats:sub>2<\/jats:sub>\n                    decreased to 15% (the lowest measurable value) bilaterally and persisted throughout the surgery. Both patients developed refractory shock and severe metabolic derangements and died shortly thereafter. We report these cases to highlight an unusual monitoring pattern in which extreme rSO\n                    <jats:sub>2<\/jats:sub>\n                    depression occurred in the context of severe sepsis and to raise the question of its physiological significance and clinical implications.\n                  <\/jats:p>","DOI":"10.4103\/sja.sja_345_26","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:00:43Z","timestamp":1782968443000},"page":"723-725","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Extremely low regional cerebral oxygen saturation during general anesthesia in severe sepsis: A report of two cases"],"prefix":"10.4103","volume":"20","author":[{"given":"Ye Lin","family":"Jeon","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Il","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"issue":"(Suppl 1)","key":"R1-20260820","doi-asserted-by":"crossref","first-page":"i3","DOI":"10.1093\/bja\/aep299","article-title":"Near-infrared spectroscopy as an index of brain and tissue oxygenation","volume":"103","author":"Murkin","year":"2009","journal-title":"Br J Anaesth"},{"key":"R2-20260820","doi-asserted-by":"crossref","first-page":"814313","DOI":"10.3389\/fcvm.2021.814313","article-title":"Effect of intraoperative cerebral oximetry monitoring on postoperative cognitive dysfunction and ICU stay: A systematic review","volume":"8","author":"Tian","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"R4-20260820","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1097\/00000542-200010000-00012","article-title":"Arterial and venous contributions to near-infrared cerebral oximetry","volume":"93","author":"Watzman","year":"2000","journal-title":"Anesthesiology"},{"key":"R5-20260820","doi-asserted-by":"crossref","first-page":"R140","DOI":"10.1186\/cc9205","article-title":"Cerebral microcirculation is impaired during sepsis: An experimental study","volume":"14","author":"Taccone","year":"2010","journal-title":"Crit Care"},{"key":"R6-20260820","doi-asserted-by":"crossref","first-page":"e114","DOI":"10.1097\/CCM.0b013e3182a641b8","article-title":"Sepsis is associated with altered cerebral microcirculation and tissue hypoxia in experimental peritonitis","volume":"42","author":"Taccone","year":"2014","journal-title":"Crit Care Med"},{"key":"R7-20260820","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1186\/s13054-018-2258-8","article-title":"Impaired cerebral autoregulation is associated with brain dysfunction in patients with sepsis","volume":"22","author":"Crippa","year":"2018","journal-title":"Crit Care"},{"key":"R9-20260820","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1016\/j.resuscitation.2013.07.026","article-title":"A pilot study examining the role of regional cerebral oxygen saturation monitoring as a marker of return of spontaneous circulation in shockable (VF\/VT) and non-shockable (PEA\/Asystole) causes of cardiac arrest","volume":"84","author":"Ahn","year":"2013","journal-title":"Resuscitation"},{"key":"R10-20260820","doi-asserted-by":"crossref","first-page":"e0234979","DOI":"10.1371\/journal.pone.0234979","article-title":"Association between cerebral oximetry and return of spontaneous circulation following cardiac arrest: A systematic review and meta-analysis","volume":"15","author":"Liu","year":"2020","journal-title":"PLoS One"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_345_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:01:34Z","timestamp":1787227294000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_345_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_345_26","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-04-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}