采用近红外光谱法进行的脑血氧饱和度监测能够在脉搏血氧饱和度测定之前检测到氧合的变化。

Cerebral oximetry monitoring with near infrared spectroscopy detects alterations in oxygenation before pulse oximetry.

作者信息

Tobias Joseph D

机构信息

Department of Anesthesiology, University of Missouri, One Hospital Drive, Columbia, MO 65212, USA.

出版信息

J Intensive Care Med. 2008 Nov-Dec;23(6):384-8. doi: 10.1177/0885066608324380.

DOI:10.1177/0885066608324380

PMID:18794168

Abstract

BACKGROUND

The monitoring of oxygenation may be imperative to ensure patient safety and optimal outcome. We anecdotally noted that monitoring cerebral oxygenation (rSO2) using near infrared spectroscopy may provide an earlier warning of changes in oxygenation than pulse oximetry.

METHODS

Patients scheduled for airway laser surgery requiring intermittent periods of apnea were monitored with both a cerebral oximeter and a pulse oximeter. Following inhalational induction and endotracheal intubation, anesthesia was maintained with propofol. After 3 minutes of ventilation with 100% oxygen, the endotracheal tube was removed and laser surgery performed on the airway during apnea. The time for a 5% and a 10% decrease in the cerebral oximeter and the pulse oximeter was noted.

RESULTS

The study cohort included 10 infants and children ranging in age from 1 month to 7 years. The time for a 5% decrease of the rSO2 was 94 + 8 seconds versus 146 + 49 seconds for a 5% decrease of the SaO 2 (P < .0001). During all 42 episodes of apnea, the rSO2 decreased by 5% before the SaO2 had decreased by 5%. When the SaO2 had decreased by 5% (down to 95% from the starting value of 100%), the rSO2 had decreased by 16 + 4%. The time for a 10% decrease of the rSO2 was 138 + 29 seconds versus 189 + 64 seconds for a 10% decrease of the SaO2 (P = .0009). In all 42 cases, the rSO2 decreased by 10% before the SaO2.

CONCLUSIONS

Cerebral oxygenation monitoring using near infrared spectroscopy detects changes in oxygenation earlier than standard pulse oximetry.

摘要

背景

监测氧合对于确保患者安全和获得最佳治疗效果可能至关重要。我们凭经验注意到，使用近红外光谱法监测脑氧合（rSO2）可能比脉搏血氧饱和度测定法更早地发出氧合变化的预警。

方法

对计划进行气道激光手术且需要间歇性呼吸暂停的患者，同时使用脑血氧仪和脉搏血氧仪进行监测。吸入诱导和气管插管后，用丙泊酚维持麻醉。在100%氧气通气3分钟后，拔出气管导管，在呼吸暂停期间对气道进行激光手术。记录脑血氧仪和脉搏血氧仪下降5%和10%的时间。

结果

研究队列包括10名年龄在1个月至7岁之间的婴儿和儿童。rSO2下降5%的时间为94±8秒，而SaO2下降5%的时间为146±49秒（P<.0001）。在所有42次呼吸暂停期间，rSO2在SaO2下降5%之前就下降了5%。当SaO2下降5%（从起始值100%降至95%）时，rSO2下降了16±4%。rSO2下降10%的时间为138±29秒，而SaO2下降10%的时间为189±64秒（P=.0009）。在所有42例病例中，rSO2在SaO2之前下降了10%。