Near-infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients
Near-infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients
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DOI：
10.1111/j.1460-9592.2008.02783.x
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发表时间：
2008-12-01
影响因子：
1.7
通讯作者：
Carlucci, Concetta
中科院分区：
文献类型：
--
作者：
Ranucci, Marco;Isgro, Giuseppe;Carlucci, Concetta
背景：用近红外光谱（NIRS）测量脑局部氧饱和度（rSO（2））具有良好的临床实用性。基于rSO（2）的目标导向治疗显著降低了接受冠状动脉血运重建术患者的主要发病率，并缩短了术后住院时间。在本研究中，我们比较了Pediasat导管连续测量的上级腔静脉饱和度（ScvO（2））值和儿科患者心脏手术期间获得的相应NIRS rSO（2）值。方法：这是一项前瞻性观察研究，纳入15例接受心脏手术的儿科患者（年龄：6天-7岁）。结果：共获得117组匹配的ScvO（2）数据。用Pediasat连续测量的ScvO（2）与相应的NIRS rSO（2）值显著相关。然而，存在5.6%的恒定正偏倚（ScvO（2）值高于NIRS rSO（2）值），精密度为10.4%。NIRS rSO（2）与ScvO（2）的时间相关性显著。ScvO（2）的降低预示rSO（2）的降低，其敏感性为73.7%，特异性为85.7%。结论：Pediasat连续测量ScvO（2）值，如果以百分比变化考虑，可提供有关小儿心脏手术期间脑代谢状况的有用信息。ScvO（2）的绝对值倾向于高估相应的rSO（2）值。
Background: Cerebral regional oxygen saturation (rSO(2)) measured with near-infrared spectroscopy (NIRS) has a well-proven clinical utility. A goal-oriented treatment based on the rSO(2) resulted in a significant reduction in major morbidity and in a shortening of postoperative hospital stay in patients undergoing coronary revascularization. In this study, we have compared the values of superior vena cava saturation (ScvO(2)) continuously measured with a Pediasat catheter and the corresponding NIRS rSO(2) values obtained during cardiac operations in pediatric patients.Methods: This was a prospective observational study enrolling fifteen pediatric patients (age: 6 days-7 years) undergoing cardiac operations. ScvO(2) data obtained with the Pediasat during the operation were compared with simultaneously recorded NIRS rSO(2) values.Results: One hundred and seventeen matched sets of data were obtained during the operation. ScvO(2) continuously measured with the Pediasat was significantly correlated with the corresponding NIRS rSO(2) values. However, there was a constant positive bias (ScvO(2) values were higher than NIRS rSO(2) values) of 5.6%, with a precision of 10.4%. Time-related percentage changes of NIRS rSO(2) were significantly correlated with the corresponding ScvO(2) percentage changes. A decrease in ScvO(2) is predictive for a decrease in rSO(2) with a sensitivity of 73.7% and a specificity of 85.7%.Conclusions: The continuous measurement of ScvO(2) values obtained by the Pediasat may provide useful information about the metabolic conditions of the brain during cardiac operations in pediatric patients if considered as percentage changes. Absolute values of ScvO(2) tend to overestimate the correspondent rSO(2) values.