在体外膜肺氧合期间使用头端套管监测颈静脉氧含量。
The use of cephalad cannulae to monitor jugular venous oxygen content during extracorporeal membrane oxygenation.
作者信息
Pettignano R, Labuz M, Gauthier TW, Huckaby J, Clark RH
机构信息
Critical Care Medicine
出版信息
Crit Care. 1997;1(3):95-99. doi: 10.1186/cc111.
BACKGROUND
When used during extracorporeal membrane oxygenation (ECMO), jugular venous bulb catheters, known as cephalad cannulae, increase venous drainage, augment circuit flow and decompress cerebral venous pressure. Optimized cerebral oxygen delivery during ECMO may contribute to a reduction in neurological morbidity. This study describes the use of cephalad cannulae and identifies rudimentary data for jugular venous oxygen saturation (JVO2) and arterial to jugular venous oxygen saturation difference (AVDO2) in this patient population. RESULTS: Patients on venoarterial (VA) ECMO displayed higher JVO2 (P < 0.01) and lower AVDO2 (P = 0.01) than patients on venovenous (VV) ECMO (P < 0.01). During VV ECMO, JVO2 was higher and AVDO2 lower when systemic pH was < 7.35 rather than > 7.4 (P = 0.01). During VA ECMO, similar differences in AVDO2 but not in JVO2 were observed at different pH levels (P = 0.01). CONCLUSIONS: Jugular venous saturation and AVDO2 were influenced by systemic pH, ECMO type and patient age. These data provide the foundation for normative values of JVO2 and AVDO2 in neonates and children treated with ECMO.
背景
在体外膜肺氧合（ECMO）期间使用时，颈静脉球导管（即头端插管）可增加静脉引流、提高回路血流量并降低脑静脉压力。ECMO期间优化的脑氧输送可能有助于降低神经发病率。本研究描述了头端插管的使用情况，并确定了该患者群体中颈静脉血氧饱和度（JVO2）和动脉与颈静脉血氧饱和度差值（AVDO2）的基础数据。结果：与接受静脉-静脉（VV）ECMO的患者相比，接受静脉-动脉（VA）ECMO的患者JVO2更高（P < 0.01），AVDO2更低（P = 0.01）（P < 0.01）。在VV ECMO期间，当全身pH < 7.35而非> 7.4时，JVO2更高，AVDO2更低（P = 0.01）。在VA ECMO期间，在不同pH水平观察到AVDO2有类似差异，但JVO2没有（P = 0.01）。结论：颈静脉饱和度和AVDO2受全身pH、ECMO类型和患者年龄影响。这些数据为接受ECMO治疗的新生儿和儿童JVO2和AVDO2的正常值提供了基础。
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