Validation of Cerebral Venous Oxygenation Measured Using Near-Infrared Spectroscopy and Partial Jugular Venous Occlusion in the Newborn Lamb
Validation of Cerebral Venous Oxygenation Measured Using Near-Infrared Spectroscopy and Partial Jugular Venous Occlusion in the Newborn Lamb
复制标题
使用近红外光谱和部分颈静脉闭塞测量新生羔羊脑静脉氧合的验证
DOI：
10.1038/sj.jcbfm.9600507
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发表时间：
2008
影响因子：
6.3
通讯作者：
A. Walker
中科院分区：
文献类型：
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作者：
F. Wong;C. Barfield;L. Campbell;V. Brodecky;A. Walker
近红外光谱分析结合部分颈静脉闭塞(JVo)为早产儿脑静脉血氧饱和度(CSvO2)的检测提供了希望，但尚未在新生儿脑内或低氧血症条件下得到验证。我们以上矢状窦血液中的脑静脉血氧饱和度(SSSO2)为‘金标准’来评估CSvO2估计的准确性。对7只新生羔羊的动脉血氧饱和度(SaO2)在20%到100%的大范围内进行了比较。总体而言，CSvO2的中位数(范围)为49.8%(10.6%至88.5%)，SSSO2为45.5%(4.3%至76.6%)；Bland-Altman分析的平均差值(CSvO2-SSSO2)为5.1%，符合度为±27.4%。JVo引起的脑血容量(Δ)的变化随血氧饱和度的增加而增加(P<；0.05)。此外，随着jVo引起的总血红蛋白浓度(ΔHbt)变化的增加，CSVO2与SSSO2的相关性强度逐渐增强。对ΔHbt&Gt；30μcm的数据进行Bland-Altman分析，平均差值(CSvO2-SSSO2)降至2.4%，符合度为±18.8%。我们的结论是，估计CSVO2的准确性随jVo引起的ΔCBV而不同。羊头和人类婴儿的光学特性的潜在差异表明，在将这些数据直接应用于人类新生儿时应谨慎行事。然而，在为患病的早产儿开发一种准确的测量方法时，需要考虑jVo技术的这一关键方面。
Near-infrared spectroscopy combined with partial jugular venous occlusion (JVO) offers promise for determining cerebral venous saturation (CSvO2) in sick preterm infants, but has not been validated in the newborn brain or under conditions of hypoxaemia. We assessed the accuracy of the CSvO2 estimate using cerebral venous oxygen saturation in superior sagittal sinus blood (SSSO2) as the ‘gold standard’. Comparisons were made in seven newborn lambs over a wide range of arterial oxygen saturations (SaO2) of 20% to 100%. Overall, median (range) CSvO2 was 49.8% (10.6% to 88.5%), whereas SSSO2 was 45.5% (4.3% to 76.6%); Bland—Altman analysis revealed a mean difference (CSvO2—SSSO2) of 5.1% and limits of agreement of ±27.4%. The change in cerebral blood volume (ΔCBV) induced by JVO increased with SaO2 (P <0.05). In addition, the strength of the correlation of CSvO2 with SSSO2 progressively improved with increasing change in total haemoglobin concentration (ΔHbT) induced by JVO. With Bland—Altman analysis repeated for data with ΔHbT >30 μmol cm, the mean difference (CSvO2—SSSO2) decreased to 2.4% with limits of agreement of ±18.8%. We conclude that the accuracy of estimating CSvO2 varies with the ΔCBV induced by JVO. Potential differences of optical properties between the head of the lamb and the human infant suggest that caution be exercised in directly applying these data to the human newborn. Nevertheless, this critical aspect of the JVO technique needs to be taken into consideration in developing an accurate measurement for sick preterm human infants.
影响因子：
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作者：
FERRARI, M;WILSON, DA;TRAYSTMAN, RJ
通讯作者：
TRAYSTMAN, RJ