Zhu Zhao-qiong, Wei Wei, Yang Zong-bin, Liu Ai-jie, Liu Jina
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2005 Jan;36(1):124-6.
To assess the sensitivity and accuracy of a novel transesophageal approach to monitoring the descending aortic oximetry (SeO2).
Nine dogs were involved in the experimental study. After the induction of anaesthesia, the carrier of the oximetry probe (Nellcor-D20, USA) was inserted into the lower segment of esophagus to monitor SeO2, and the probe was "locked" in position of post-descending aorta after the opening of thoracic cavity. Another probe was pasted on the surface of lingual mucous membrane. The readings and figures of SeO2 and surface of lingual mucosa oximetry (SmO2) were observed continuously and recorded simultaneously. Vital signs were monitored with pulse oxygen saturation (SpO2), invasive blood pressure by femoral artery, HR, EKG, PetCO2, T, FiO2. The SaO2 of blood gas analysis by femoral artery was used as the "gold standard" to calculated the relative and absolute deviations of SeO2 and SmO2. The changes of SeO2 and SaO2 were compared in case of acute hypoxia when values of SmO2 dropped to 90%, 80%, 70%, 60% and the patient was re-ventilated with 100% oxygen.
(1) SeO2, SmO2 and SaO2 were 100% when the patients were ventilated with 100% oxygen. During hypoxia, the descent of SeO2 from 100% to 90% was (91.03+/-20.23) s (P<0.001) earlier than that of SmO2. And after re-supply of pure oxygen, the ascent of SeO2 was (25.9+/-6.0) s (P<0.05) earlier than that of SmO2. (2) SaO2 was well related with SeO2 and SmO2 (R2: 0.9884 and 0.9296) respectively. The relative and absolute deviations of SeO2 were 1.6% and 1.3%, while those of SmO2 were 7.6% and 6.1% from arterial blood samples SaO2. (3) There were no significant differences in MAP, HR, ECG, PetCO2 and T.
This study showed that SeO2 monitoring is sensitive. It could accurately reflect the arterial oxygen saturation not only in normal condition but also during hypoxia and the re-ventilation with 100% oxygen. SeO2 responds faster and is closer to SaO2, compared with SmO2 measurements. This may be an alternative method in the cases where the monitoring of peripheral SpO2 is difficult.
评估一种新型经食管监测降主动脉血氧饱和度（SeO2）方法的敏感性和准确性。
9只犬参与实验研究。麻醉诱导后，将血氧饱和度探头（美国Nellcor-D20）的载体插入食管下段监测SeO2，胸腔打开后将探头“锁定”在降主动脉后方位置。另一个探头粘贴在舌黏膜表面。连续观察并同步记录SeO2和舌黏膜表面血氧饱和度（SmO2）的读数及数值。通过脉搏血氧饱和度（SpO2）、股动脉有创血压、心率、心电图、呼气末二氧化碳分压（PetCO2）、体温（T）、吸入氧浓度（FiO2）监测生命体征。以股动脉血气分析的SaO2作为“金标准”，计算SeO2和SmO2的相对及绝对偏差。当SmO2值降至90%、80%、70%、60%且患者用100%氧气重新通气时，比较急性缺氧情况下SeO2和SaO2的变化。
（1）患者用100%氧气通气时，SeO2、SmO2和SaO2均为100%。缺氧期间，SeO2从100%降至90%的时间为（91.03±20.23）秒（P<0.001），早于SmO2。重新供应纯氧后，SeO2上升的时间为（25.9±6.0）秒（P<0.05），早于SmO2。（2）SaO2与SeO2和SmO2分别具有良好的相关性（R2：0.9884和0.9296）。SeO2相对于动脉血样本SaO2的相对偏差和绝对偏差分别为1.6%和1.3%，而SmO2的相对偏差和绝对偏差分别为7.6%和6.1%。（3）平均动脉压（MAP）、心率（HR）、心电图（ECG）、呼气末二氧化碳分压（PetCO2）和体温（T）无显著差异。
本研究表明，SeO2监测具有敏感性。它不仅能在正常状态下准确反映动脉血氧饱和度，还能在缺氧及用100%氧气重新通气期间准确反映。与SmO2测量相比，SeO2反应更快且更接近SaO2。在难以监测外周SpO2的情况下，这可能是一种替代方法。
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