Near-infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation
Near-infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation
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DOI：
10.1111/j.1460-9592.2005.01404.x
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发表时间：
2005-02-01
影响因子：
1.7
通讯作者：
Baenziger, O
中科院分区：
文献类型：
--
作者：
Weiss, M;Dullenkopf, A;Baenziger, O
背景：该研究的目的是阐明临床实践中易于测定的实验室和生命参数，以解释使用Niro 300光谱仪对危重新生儿和婴儿脑氧合指数的近红外光谱读数的变异性。方法：测量危重新生儿和婴儿额部的近红外光谱脑组织氧合指数(CTOI)。记录患者特征，同时测定镇静状态、血流动力学、呼吸和实验室数据，如动脉血气分析、电解质、血红蛋白和动脉乳酸浓度、血糖和中心静脉血氧饱和度。数据比较采用线性、多元和逐步回归分析(P<；0.05)。结果：共调查155名0~365天(中位数12天)的新生儿和婴儿。脑组织氧合指数(CTOI)为32.1~91.0%(60.5+/-11.5%)。简单线性回归分析显示，CTOI与动脉血氧饱和度(r=0.254，P=0.001)、经皮测得的动脉血氧饱和度(r=0.320，P<0.0001)、中心静脉血氧饱和度(r=0.489，P=0.0001)、动静脉血氧摄取量(r=0.445，P=0.0001)、心脏分流(r=0.250，P=0.024)显著相关。多元回归分析和前向逐步回归分析显示两个独立的显著预测因素，即SvO(2)(P<；0.0001)和有无心脏分流(P=0.003)。仅SVO(2)一项就能解释23.9%的cTOI变异。结论：根据我们的研究结果，Niro 300近红外光谱仪的脑组织氧合读数受到中心静脉血氧饱和度的影响，这部分解释了NIRS脑氧合读数的受试者间变异性。
Background: The aim of the study was to elucidate easily determinable laboratory and vital parameters in clinical practice to explain variability of near-infrared spectroscopic cerebral oxygenation readings in critically ill newborns and infants using the NIRO 300 spectrometer.Methods: Near-infrared spectroscopy (NIRS) cerebral tissue oxygenation index (cTOI) was measured on the forehead of critically ill neonates and infants with existing arterial and/or central venous access. We recorded patient characteristics and simultaneously determined sedation state, hemodynamic, respiratory and laboratory data, such as arterial blood gas analysis, electrolytes, hemoglobin and arterial lactate concentration, blood glucose and central venous oxygen saturation. Data were compared using linear, multiple and forward stepwise regression analysis (P < 0.05).Results: A total of 155 neonates and infants aged from 0 to 365 days (median 12 days) were studied. cerebral tissue oxygenation index (cTOI) values ranged from 32.1 to 91.0% (60.5 +/- 11.5%). Simple linear regression analysis revealed significant associations between cTOI and arterial oxygen saturation (r = 0.254, P = 0.001), transcutaneously measured arterial oxygen saturation (r = 0.320, P less than or equal to 0.0001), central venous oxygen saturation (r = 0.489, P < 0.0001), arteriovenous oxygen extraction (r = 0.445, P < 0.0001) and presence of a cardiac shunt (r = 0.250, P = 0.024). Multiple regression analysis and forward stepwise regression revealed two independent, significant predictors for cTOI, namely SvO(2) (P < 0.0001) and presence or absence of a cardiac shunt (P = 0.003). SvO(2) alone explained 23.9% of the variability of cTOI. The addition of the variable 'cardiac shunt' improved the model to 33%.Conclusions: Based on our study results cerebral tissue oxygenation readings by the NIRO 300 near-infrared spectrometer is influenced by central venous oxygen saturation, which partially explains intersubject variability of NIRS cerebral oxygenation readings.