Monitoring for compartmental syndrome using near-infrared spectroscopy: A noninvasive, continuous, transcutaneous monitoring technique
Monitoring for compartmental syndrome using near-infrared spectroscopy: A noninvasive, continuous, transcutaneous monitoring technique
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DOI：
10.1097/00005373-199904000-00009
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发表时间：
1999-04-01
影响因子：
--
通讯作者：
Matsen, FA
中科院分区：
文献类型：
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作者：
Garr, JL;Gentilello, LM;Matsen, FA
背景资料：房室综合征（CS）的诊断可能会延迟，因为目前的监测技术是侵入性的和间歇性的，预测缺血的室间隔压力（CP）是可变的。使用近红外（NIR）波长反射的光纤装置可以确定光吸收分子的氧化还原状态，并且已经用于监测静脉血红蛋白饱和度以检测低流量状态期间的缺血。本研究的目的是确定近红外光谱是否可以提供连续的，经皮的，非侵入性的监测肌肉缺血的动物模型CS.Methods：9只猪被麻醉和20毫米NTR探头放置在前外侧间室的后腿，以提供连续测定肌肉氧合血红蛋白水平。将针插入间隔中以测量CP，将神经刺激器放置在腓神经上以诱导背屈抽搐，将白蛋白注入肌肉中以递增地增加CP，直到背屈完全丧失，然后在20分钟后进行筋膜切开术。CP和氧合血红蛋白水平之间存在显著的负相关性（r = -0.78; p < 0.001），氧合血红蛋白和灌注压（平均动脉压减去CP）之间存在相关性（r = 0.66; p < 0.001）。结论：近红外光谱仪测量的肌氧合血红蛋白水平能较好地反映CP、灌注压和背屈肌颤的丧失，便携式近红外装置可为CS提供连续、无创的监测，进一步研究该技术在房室综合征检测中的作用是必要的。
Background: The diagnosis of compartmental syndrome (CS) may be delayed because current monitoring techniques are invasive and intermittent and the compartment pressure (CP) that predicts ischemia is variable. Fiber-optic devices using near-infrared (NIR) wavelength reflection can determine the redox state of light-absorbing molecules and have been used to monitor venous hemoglobin saturation to detect ischemia during low-flow states. The purpose of this study was to determine if NIR spectroscopy can provide continuous, transcutaneous, noninvasive monitoring for muscle ischemia in an animal model of CS.Methods: Nine swine were anesthetized and a 20-mm NTR probe was placed over the anterolateral compartment of the hind leg to provide continuous determination of muscle oxyhemoglobin level. Needles were inserted into the compartment to measure CP, A nerve stimulator was placed over the peroneal nerve to induce dorsiflexion twitch, Albumin was infused into the muscle to incrementally increase CP until there was complete loss of dorsiflexion, then after 20 minutes fasciotomy was performed.Results: All animals lost dorsiflexion at CP of 43 +/- 14 mm Hg. There was a significant inverse correlation between CP and oxyhemoglobin level (r = -0.78; p < 0.001) and a correlation between oxyhemoglobin and perfusion pressure (mean arterial pressure minus CP) (r = 0.66; p < 0.001). Redox state was a more consistent predictor of twitch loss than perfusion pressure.Conclusion: Muscle oxyhemoglobin level measured by NIR spectroscopy strongly reflected CP, perfusion pressure, and loss of dorsiflexion twitch, Currently available portable NIR devices may provide the benefit of continuous, noninvasive monitoring for CS, Further studies to determine the role of this technology in the detection of compartmental syndrome are warranted.