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IN RECENT YEARS, frontal cortex tissue saturation (rSO2) using near-infrared spectroscopy (NIRS) has been serving as continuous, noninvasive monitoring of balance between cerebral oxygen delivery and consumption in the operating room (OR) setting. In the authors’ center, cerebral NIRS has been used for more than 15 years during cardiac surgeries. 1 Since 2013, the authors frequently have used the rSO2 electrodes during the early postoperative period of cardiac surgery patients. This was the consequence of one single center and one multicenter trial by Deschamps et al that showed that brain desaturation in the intensive care unit (ICU) is as common as it is in the operating room. 2, 3 However, the role of NIRS in the ICU remains controversial for several reasons. These include the relatively small sensor area coverage, sampling errors, extracranial contamination, 4 prohibitive cost, lack of extensive …