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儿童脑组织氧合指数与中心静脉血氧饱和度的关系

Relation of cerebral tissue oxygenation index to central venous oxygen saturation in children.

作者信息

Nagdyman Nicole, Fleck Thilo, Barth Sven, Abdul-Khaliq Hashim, Stiller Brigitte, Ewert Peter, Huebler Michael, Kuppe Hermann, Lange Peter E

机构信息

Department of Intensive Care and Paediatric Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.

出版信息

Intensive Care Med. 2004 Mar;30(3):468-71. doi: 10.1007/s00134-003-2101-8. Epub 2004 Jan 13.

Abstract

OBJECTIVE

To evaluate the relationship between the cerebral tissue oxygenation index measured by near-infrared spectroscopy and central venous oxygen saturation (SvO2) after corrective surgery of congenital heart defects in children.

DESIGN

Prospective observational clinical study.

SETTING

A tertiary neonatal and paediatric intensive care unit for paediatric cardiology.

PATIENTS

Neonates and children consecutively admitted to the paediatric cardiology intensive care unit after corrective surgery of non-cyanotic congenital heart defects.

MEASUREMENTS AND RESULTS

Forty-three children were studied. Cerebral tissue oxygenation index, measured non-invasively by near-infrared spectroscopy, was compared to SvO2, measured by a catheter placed in the right atrium, and to haemodynamic and respiratory parameters. Pearson's correlation coefficients and p values were calculated. Simultaneously measured values for SvO2 (62.2+/-9.8%, 39.8-80.4%) and cerebral tissue oxygenation index (56.7+/-8.8%, 35.8-71.2%) showed a significant correlation ( r=0.52, p<0.001).

CONCLUSION

Cerebral tissue oxygenation index and SvO2 are not interchangeable parameters, but cerebral tissue oxygenation index reflects the haemodynamic influence on cerebral oxygenation after cardiovascular surgery. Further work is necessary to confirm the clinical role of continuous non-invasive measurement of cerebral tissue oxygenation index with regard to the variations of global systemic oxygen consumption after cardiac surgery in children.

摘要

目的

评估儿童先天性心脏病矫正手术后,通过近红外光谱法测量的脑组织氧合指数与中心静脉血氧饱和度(SvO2)之间的关系。

设计

前瞻性观察性临床研究。

地点

一家三级新生儿及儿科重症监护病房的儿科心脏病科。

患者

非紫绀型先天性心脏病矫正手术后连续入住儿科心脏病重症监护病房的新生儿和儿童。

测量与结果

对43名儿童进行了研究。将通过近红外光谱法无创测量的脑组织氧合指数与通过置于右心房的导管测量的SvO2以及血流动力学和呼吸参数进行比较。计算了Pearson相关系数和p值。同时测量的SvO2值(62.2±9.8%,39.8 - 80.4%)和脑组织氧合指数值(56.7±8.8%,35.8 - 71.2%)显示出显著相关性(r = 0.52,p < 0.001)。

结论

脑组织氧合指数和SvO2不是可互换的参数,但脑组织氧合指数反映了心血管手术后血流动力学对脑氧合的影响。有必要进一步开展工作,以确认连续无创测量脑组织氧合指数在儿童心脏手术后全身氧耗变化方面的临床作用。

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