Direct Optical Measurement of Intraoperative Myocardial Oxygenation During Congenital Heart Surgery
Direct Optical Measurement of Intraoperative Myocardial Oxygenation During Congenital Heart Surgery
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DOI：
10.1097/mat.0b013e3182179881
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发表时间：
2011-07-01
期刊：
影响因子：
4.2
通讯作者：
Schenkman, Kenneth A.
中科院分区：
文献类型：
--
作者：
Cohen, Gordon A.;Permut, Lester C.;Schenkman, Kenneth A.
这项研究证明了使用新技术来测量细胞氧合在矫正先天性心脏病手术。使用放置在右心室游离壁上的定制设计的光学探针测量细胞氧合。使用多波长分析计算从肌红蛋白饱和度确定的细胞氧合。记录转流时间、主动脉阻断、心脏停搏液输注和重症监护室（ICU）住院时间。在主动脉阻断前，基线细胞氧合约为50%，在心脏停搏期间降至约20%。细胞氧合在整个心脏停搏过程中保持较低水平，并在旁路手术后恢复至基线水平。在四个病例中，细胞氧合没有像其他三个病例那样迅速恢复到基线。在4例恢复缓慢的患者中，ICU平均住院时间为2.25天，而细胞氧合快速恢复的患者平均住院时间为1.33天（p = 0.06）。缓慢恢复组的平均交叉钳夹时间为40.1 ± 28.4分钟，而快速恢复组为26.0 ± 8.5分钟（p = 0.34）。这项研究首次证明，心肌细胞氧合可以在心脏手术中测量。细胞氧合的测量可能有助于改善心肌保护技术。ASAIO Journal 2011; 57：314-317.
This study demonstrates use of novel technology to measure cellular oxygenation during corrective congenital heart surgery. Cellular oxygenation was measured using a custom-designed optical probe placed on the free wall of the right ventricle. Cellular oxygenation, determined from myoglobin saturation, was calculated using multiwavelength analysis. Timing of bypass, aortic cross-clamp, infusion of cardioplegic solution, and length of intensive care unit (ICU) stay were recorded. Baseline cellular oxygenation was approximately 50% just before aortic cross-clamp and decreased to approximately 20% during cardioplegia. Cellular oxygenation remained low throughout cardioplegia and returned toward baseline after bypass. In four cases, cellular oxygenation did not return as quickly to baseline as in the other three cases. Among the four patients demonstrating slow recovery, the average ICU length of stay was 2.25 days compared with an average stay of 1.33 days for those patients exhibiting rapid cellular oxygenation recovery (p = 0.06). The slow recovery group had an average cross-clamp time of 40.1 +/- 28.4 minutes, compared with 26.0 +/- 8.5 minutes for the fast recovery group (p = 0.34). This study demonstrates for the first time that myocyte cellular oxygenation can be measured intraoperatively during cardiac surgery. Measurement of cellular oxygenation may be useful for improving myocardial preservation techniques. ASAIO Journal 2011; 57:314-317.