Cerebral Hyperemia Measured with Near Infrared Spectroscopy during Treatment of Diabetic Ketoacidosis in Children
Cerebral Hyperemia Measured with Near Infrared Spectroscopy during Treatment of Diabetic Ketoacidosis in Children
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DOI：
10.1016/j.jpeds.2013.06.008
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发表时间：
2013-10-01
影响因子：
5.1
通讯作者：
Kuppermann, Nathan
中科院分区：
文献类型：
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作者：
Glaser, Nicole S.;Tancredi, Daniel J.;Kuppermann, Nathan
目的应用近红外光谱（NIRS）技术评价糖尿病酮症酸中毒（DKA）患儿治疗过程中脑充血的发生时间和持续时间，并探讨脑充血与静脉补液治疗的关系。研究设计我们将8-18岁的DKA患儿随机分为快速或慢速静脉补液治疗组（共19例DKA发作）。用近红外光谱法测定DKA治疗期间rSO（2）。结果19例DKA患者中有17例rSO（2）值高于正常范围（>80%）（治疗前8 h rSO（2）平均值为86% ± 7%，范围65%~ 95%）。早在DKA治疗的第二个小时就检测到rSO（2）值升高，并持续长达27小时。治疗期间的每小时平均rSO（2）水平在液体治疗组之间没有显著差异。结论在DKA治疗期间，儿童rSO（2）值升高，与脑充血一致。充血早在DKA治疗的第二小时发生，并可能持续>= 27小时。在治疗期间，缓慢静脉补液与快速静脉补液患者的脑rSO（2）水平无显著差异。
Objective To use near infrared spectroscopy (NIRS) to evaluate the timing of onset and duration of cerebral hyperemia during diabetic ketoacidosis (DKA) treatment in children, and to investigate the relationship of cerebral hyperemia to intravenous fluid treatment.Study design We randomized children aged 8-18 years with DKA to either more rapid or slower intravenous fluid treatment (19 total DKA episodes). NIRS was used to measure rSO(2) during DKA treatment. NIRS monitoring began as soon as informed consent was obtained and continued until the patient was transferred out of the critical care unit.Results rSO(2) values above the normal range (>80%) were detected in 17 of 19 DKA episodes (mean rSO(2) during initial 8 hours of DKA treatment: 86% +/- 7%, range 65%-95%). Elevated rSO(2) values were detected as early as the second hour of DKA treatment and persisted for as long as 27 hours. Hourly mean rSO(2) levels during treatment did not differ significantly by fluid treatment group.Conclusions During DKA treatment, children have elevated rSO(2) values consistent with cerebral hyperemia. Hyperemia occurs as early as the second hour of DKA treatment and may persist for >= 27 hours. Cerebral rSO(2) levels during treatment did not differ significantly in patients treated with slower versus more rapid intravenous rehydration.