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新生儿和小婴儿中心静脉血氧饱和度的连续监测:两种不同血氧饱和度测定导管的体外评估

Continuous monitoring of central venous oxygen saturation in neonates and small infants: in vitro evaluation of two different oximetry catheters.

作者信息

Huber Dirk, Osthaus Wilhelm A, Optenhöfel Jörg, Breymann Thomas, Marx Gernot, Piepenbrock Siegfried, Sümpelmann Robert

机构信息

Zentrum Anästhesiologie, Medizinische Hochschule Hannover, Germany.

出版信息

Paediatr Anaesth. 2006 Dec;16(12):1257-61. doi: 10.1111/j.1460-9592.2006.01980.x.

Abstract

BACKGROUND

Accurate assessment and monitoring of the cardiocirculatory function are essential during major pediatric and pediatric cardiac surgery. Monitoring of the central venous oxygen saturation (ScvO(2)) may be a better indicator of tissue oxygenation and derangement of cellular oxygen utilization than the more commonly used vital parameters. Therefore, we compared oxygen saturation measurements with thin fiberoptic oximetry catheters and standard blood gas oximetry in an in vitro setting.

METHODS

Two different size continuous fiberoptic oximetry catheters (2-4-F) were inserted in an extracorporeal circuit filled with human red blood cells in normal saline (haematocrit 30%, flow 600 ml.min(-1)). The results of fiberoptic oximetry were then compared with standard blood gas oximetry for a wide range of different oxygen saturations using linear regression.

RESULTS

The oxygen saturations found ranged from 9% to 100%. The results of the two different fiberoptic oximetry catheters correlated significantly (r = 0.99, P < 0.0001) with standard blood gas oximetry.

CONCLUSION

The results of fiberoptic oximetry are nearly identical with standard blood gas oximetry for a wide range of different oxygen saturations. Thin oximetry catheters can be inserted percutaneously even in neonates and small infants. The continuous monitoring of ScvO(2) may be beneficial, especially in patients who are in danger of developing low cardiac output or sudden cardiovascular collapse.

摘要

背景

在小儿重大手术及小儿心脏手术过程中,准确评估和监测心脏循环功能至关重要。与更常用的生命体征参数相比,监测中心静脉血氧饱和度(ScvO₂)可能是组织氧合及细胞氧利用紊乱的更好指标。因此,我们在体外环境中比较了使用细光纤血氧饱和度测定导管和标准血气血氧饱和度测定法测得的血氧饱和度。

方法

将两种不同尺寸的连续光纤血氧饱和度测定导管(2-4F)插入充满生理盐水(血细胞比容30%,流速600 ml·min⁻¹)中人体红细胞的体外循环装置。然后,使用线性回归将光纤血氧饱和度测定结果与标准血气血氧饱和度测定法在广泛的不同血氧饱和度下的结果进行比较。

结果

测得的血氧饱和度范围为9%至100%。两种不同的光纤血氧饱和度测定导管的结果与标准血气血氧饱和度测定法显著相关(r = 0.99,P < 0.0001)。

结论

在广泛的不同血氧饱和度下,光纤血氧饱和度测定结果与标准血气血氧饱和度测定法几乎相同。细的血氧饱和度测定导管甚至可经皮插入新生儿和小婴儿体内。持续监测ScvO₂可能有益,尤其是对于有发生低心排血量或突然心血管衰竭风险的患者。

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