Grubhofer G, Tonninger W, Keznickl P, Skyllouriotis P, Ehrlich M, Hiesmayr M, Lassnigg A
Department of Cardiothoracic and Vascular Anaesthesia & Intensive Care, University Clinic of Vienna, Austria.
Acta Anaesthesiol Scand. 1999 Apr;43(4):470-5. doi: 10.1034/j.1399-6576.1999.430417.x.
Measurements of cerebral haemoglobin oxygenation of 2 near-infrared spectroscopy devices (INVOS 3100 and NIRO 500) were compared during and after hypocapnia.
Fifteen awake, healthy volunteers, who hyperventilated to obtain end-tidal CO2 (EtCO2) values of approximately 20 mmHg, were studied. During hyperventilation and 8 min thereafter, EtCO2, INVOS 3100 (RSO2 = regional cerebral oxygenation) and NIRO 500 recordings (HbO2 = oxyhaemoglobin, Hb = deoxyhaemoglobin, Hb-diff = HbO2-Hb, CtO2 = oxidised cytochrome oxidase aa3) were analysed.
Hyperventilation induced a significant decline in EtCO2 from 30.5 to 14.7 mmHg (P < 0.001) and RSO2 from 67.1% to 62.7% (P = 0.025). At hypocapnia, only Hb (+1.61 +/- 0.48 mumol/L; P < 0.001) and Hb-diff (-3.01 +/- 2.0 mumol/L; P < 0.001) indicated a decline in cerebral haemoglobin oxygenation. Within 8 min after hyperventilation, both EtCO2 and RSO2 normalised to values insignificantly different from baseline. In contrast, Hb and Hb-diff remained significantly different (Hb: +2.52 +/- 1.28 mumol/l; P < 0.001, Hb-diff: -4.31 +/- 4.0 mumol/L; P < 0.001). A correlation with EtCO2 was found for RSO2 (R = 0.35; P < 0.001) and CtO2 (R = 0.42; P < 0.001). All volunteers were continuously awake and none presented clinical symptoms of cerebral hypoxia.
Changes in cerebral haemoglobin oxygenation state were reflected more accurately by INVOS 3100 than NIRO 500. The cause may be the different technology of the monitors, since INVOS 3100 eliminates the contribution of extracranial oxygenation.
比较了低碳酸血症期间及之后两种近红外光谱设备(INVOS 3100和NIRO 500)对脑血红蛋白氧合的测量结果。
研究了15名清醒的健康志愿者,他们通过过度通气使呼气末二氧化碳(EtCO2)值达到约20 mmHg。在过度通气期间及之后8分钟内,对EtCO2、INVOS 3100(RSO2 = 局部脑氧合)和NIRO 500记录(HbO2 = 氧合血红蛋白,Hb = 脱氧血红蛋白,Hb-diff = HbO2-Hb,CtO2 = 氧化型细胞色素氧化酶aa3)进行分析。
过度通气导致EtCO2从30.5 mmHg显著降至14.7 mmHg(P < 0.001),RSO2从67.1%降至62.7%(P = 0.025)。在低碳酸血症时,只有Hb(+1.61 ± 0.48 μmol/L;P < 0.001)和Hb-diff(-3.01 ± 2.0 μmol/L;P < 0.001)显示脑血红蛋白氧合下降。过度通气后8分钟内,EtCO2和RSO2均恢复至与基线值无显著差异的水平。相比之下,Hb和Hb-diff仍有显著差异(Hb:+2.52 ± 1.28 μmol/l;P < 0.001,Hb-diff:-4.31 ± 4.0 μmol/L;P < 0.001)。发现RSO2(R = 0.35;P < 0.001)和CtO2(R = 0.42;P < 0.001)与EtCO2存在相关性。所有志愿者均持续清醒,且无一人出现脑缺氧的临床症状。
与NIRO 500相比,INVOS 3100能更准确地反映脑血红蛋白氧合状态的变化。原因可能是监测仪的技术不同,因为INVOS 3100消除了颅外氧合的影响。