NEAR-INFRARED SPECTROSCOPY USE IN PATIENTS WITH HEAD-INJURY
NEAR-INFRARED SPECTROSCOPY USE IN PATIENTS WITH HEAD-INJURY
复制标题
DOI：
10.3171/jns.1995.83.6.0963
复制
发表时间：
1995-12-01
影响因子：
4.1
通讯作者：
PICKARD, JD
中科院分区：
文献类型：
--
作者：
KIRKPATRICK, PJ;SMIELEWSKI, P;PICKARD, JD
在14例闭合性颅脑损伤的通气患者中使用了多模态记录系统，以评估近红外光谱（NIRS）在神经重症监护病房中的潜在用途。数字化并记录颅内压、脑灌注压、外周血氧饱和度、颈静脉血氧饱和度以及氧合血红蛋白和脱氧血红蛋白的发色团的NIRS衍生变化的信号。在对886小时的连续监测进行审查后，认为376小时无伪影，并输入进行最终分析。在9例患者中，记录了38起事件，这些事件表明脑灌注压明显变化，伴有大脑中动脉血流速度（经颅多普勒）和皮质灌注（激光多普勒血流仪）的血液动力学变化。近红外光谱显示37例事件（97%）发生相关变化，而颈静脉饱和度监测仅记录了20例（53%）。8例（21%）伴有外周氧饱和度下降，10例（26%）伴有颅内高压，8例（21%）伴有脑充血。其余12起事件（32%）似乎是起源不确定的复杂变化。医源性因素被确定为14例（37%）的病因。近红外光谱在成人的潜在应用和使用多参数记录系统在解释脑事件的重要性进行了讨论。
A multimodality recording system was used in 14 ventilated patients with closed head injury to assess the potential use of near-infrared spectroscopy (NIRS) in the neurointensive care unit. Signals of intracranial pressure, cerebral perfusion pressure, peripheral oxygen saturation, jugular venous saturation, and NIRS-derived changes in the chromophores of oxy- and deoxyhemoglobin were digitized and recorded. After a review of 886 hours of continuous monitoring, 376 hours were considered free from artifact and were entered for final analysis. In nine of the patients 38 events were recorded that demonstrated clear changes in cerebral perfusion pressure accompanied by hemodynamic changes in middle cerebral artery flow velocity (transcranial Doppler) and cortical perfusion (laser Doppler flowmetry). Near-infrared spectroscopy showed correlated changes in 37 events (97%) whereas jugular venous saturation monitoring registered only 20 (53%). There was associated peripheral oxygen desaturation in eight cases (21%), intracranial hypertension in 10 (26%), and cerebral hyperemia in eight (21%). The remaining 12 events (32%) appeared to be complex changes of uncertain origin. Iatrogenic factors were identified as causative in 14 cases (37%). The potential application of NIRS in adults and the importance of using multiple parameter recording systems in the interpretation of cerebral events are discussed.