Monitoring of Brain Oxygenation During and After Cardiopulmonary Resuscitation: A Prospective Porcine Study.
Monitoring of Brain Oxygenation During and After Cardiopulmonary Resuscitation: A Prospective Porcine Study.
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心肺复苏期间和之后的脑氧合监测：一项前瞻性猪研究。
DOI：
10.1007/978-3-319-91287-5_14
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Ito T.
中科院分区：
文献类型：
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作者：
Kakihana Y;Kamikokuryo C;Furubeppu H;Madokoro Y;Futatsuki T;Miyamoto S;Haraura H;Hatanaka K;Eguchi T;Saitoh Y;Miura N;Suzuki H;Ueda Y;Yasuda T;Ito T.
本研究旨在评估近红外时间分辨光谱（TRS）用于监测复苏后脑病的有用性。通过电刺激诱导猪心脏骤停（CA），然后通过直流电实现自主循环恢复（ROSC）。采用两种方法分析脑氧合的变化：（1）基于修正的Beer-Lambert定律（MBL）的非时性计算;（2）基于光子扩散理论（DT）的曲线拟合。计算了DT中约化散射系数（μs′）的变化。通过MRI结果评估复苏后脑病。在CA期间，脑氧饱和度（ScO 2）降至最低水平，然后在胸外按压期间逐渐升高。当达到ROSC时，ScO 2（DT）进一步升高，但ScO 2（MBL）短暂下降。当头皮被剥下来，探针直接固定在颅骨上时，这种奇怪的现象就消失了。在某些病例中，在ROSC后几小时观察到μs′持续降低，在这些病例中，MRI弥散增强图像（DWI）显示提示复苏后脑病的结果。总之，MBL和DT同时监测脑氧合可以提供更多关于不同层次血管反应的信息。μs′的监测有助于我们真实的认识复苏后脑病的发生。
This study aimed to evaluate the usefulness of near-infrared time-resolved spectroscopy (TRS) for the monitoring of post-resuscitation encephalopathy. Cardiac arrest (CA) was induced in pigs by electrical stimuli; then, return of spontaneous circulation (ROSC) was achieved by direct current. The changes in cerebral oxygenation were analyzed by two methods: (1) the time-independent calculation based on the modified Beer-Lambert law (MBL), and (2) the curve-fitting method based on the photon diffusion theory (DT). The changes in reduced scattering coefficient (μs′) in DT were also calculated. Post-resuscitation encephalopathy was evaluated by MRI findings. During CA, cerebral oxygen saturation (ScO2) decreased to the lowest level, and then gradually increased during the chest compression period. When ROSC was achieved, ScO2(DT) increased further, but ScO2(MBL) decreased transiently. This strange phenomenon disappeared when the scalp was peeled off and the probes were directly fixed to the cranial bone. In some cases, a sustained decrease in μs′ was observed several hours after ROSC and, in such cases, MRI Diffusion Enhancement Image (DWI) showed findings suggestive of post-resuscitation encephalopathy. In conclusion, simultaneous monitoring of cerebral oxygenation with MBL and DT may provide more information about the vascular response of different layers. Also, the monitoring of μs′ may help us to recognize the occurrence of post-resuscitation encephalopathy in real time.