Brain tissue oxygen saturation (StO₂) from near-infrared spectroscopy (NIRS) can be used to calculate the cerebral oximetry index (COx) and derive the mean arterial pressure (MAP) at which autoregulation is most intact, termed MAPopt. 1

Spending a greater proportion of time above MAPopt is linked to positive outcomes, motivating interest in systems that compute MAPopt in real time at the bedside. 2

While several commercial systems exist, no gold-standard algorithm has been established, and MAPopt values have not been directly compared. 3

Differences in artifact reduction (AR) or algorithm implementation may result in divergent MAPopt estimates across systems, leading to potentially unnecessary or harmful interventions, or risking inadequate cerebral perfusion.