Differences in tissue oxygenation and changes in total hemoglobin signal strength in the brain, liver, and lower-limb muscle during hemodialysis
Differences in tissue oxygenation and changes in total hemoglobin signal strength in the brain, liver, and lower-limb muscle during hemodialysis
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DOI：
10.1007/s10047-017-0978-1
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发表时间：
2018-03-01
影响因子：
1.3
通讯作者：
Morishita, Yoshiyuki
中科院分区：
文献类型：
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作者：
Ookawara, Susumu;Ito, Kiyonori;Morishita, Yoshiyuki
近红外光谱已被用于测量区域的氧饱和度（rSO（2））的基础上总血红蛋白（t-Hb）的信号强度。迄今为止，很少有研究探讨血液透析（HD）过程中全身氧合和t-Hb信号强度的变化。本研究旨在（1）监测HD期间脑、肝脏和下肢肌肉中的rSO（2）和t-Hb信号强度，（2）阐明各隔室中rSO（2）和t-Hb信号强度的差异。纳入了53例接受4小时HD的患者，并根据测量组织氧合的区域分为3组：脑（n = 44）、肝脏（n = 42）和下肢肌肉（n = 40）。使用INVOS 5100 c（Covidien Japan，Tokyo，Japan）监测rSO（2）和t-Hb信号强度。从HD开始到结束，脑中的rSO（2）水平显著低于肝脏（HD开始：脑和肝脏中的rSO（2）分别为46.5 +/- 1.3和52.4 +/-1.7%，p = 0.031）。此外，与HD期间脑中的t-Hb信号强度比[HD期间t（min）时的值/HD前的初始值]相比，肝脏和下肢肌肉分别显著增加。总之，与血液透析患者的肝氧合相比，脑氧合的恶化是显著的。我们的研究结果显示，血液透析过程中脑、肝和下肢肌肉中t-Hb信号强度比存在显著差异，这可能反映了超滤引起的全身组织内体液减少的不均匀性。
Near-infrared spectroscopy has been used to measure regional saturation of oxygen (rSO(2)) based on the total hemoglobin (t-Hb) signal strength. To date, few studies have investigated the changes of systemic oxygenation and t-Hb signal strength during hemodialysis (HD). This study aimed to (1) monitor rSO(2) and t-Hb signal strength in the brain, liver, and lower-limb muscle during HD and (2) clarify the differences in rSO(2) and t-Hb signal strength in each compartment. Fifty-three patients receiving 4-h HD were included and divided into three groups according to the compartments in which tissue oxygenation was measured as follows: brain (n = 44), liver (n = 42), and lower-limb muscle (n = 40). The rSO(2) and t-Hb signal strength was monitored using an INVOS 5100c (Covidien Japan, Tokyo, Japan). The rSO(2) levels were significantly lower in the brain than in the liver from HD initiation to the end (HD initiation: rSO(2) in the brain and liver, 46.5 +/- 1.3 and 52.4 +/- 1.7%, respectively, p = 0.031). Furthermore, compared to the t-Hb signal strength ratio [value at t (min) during HD/initial value before HD] in the brain during HD, there were significant increases in the liver and lower-limb muscle, respectively. In conclusion, deterioration of cerebral oxygenation was remarkable compared to the hepatic oxygenation in HD patients. Our results, which revealed significant differences among the t-Hb signal strength ratios in the brain, liver, and lower-limb muscle during HD, might reflect the non-uniform body-fluid reduction within systemic tissues induced by ultrafiltration.