Lemmers Petra M A, van Bel Frank
Department of Neonatology, University Medical Center/Wilhelmina Children's Hospital, 3584 EA Utrecht, The Netherlands.
Pediatr Res. 2009 Feb;65(2):226-30. doi: 10.1203/PDR.0b013e318191fb5d.
In a prospective study, we monitored simultaneously left and right parieto-frontal-cerebral oxygen saturation (rScO2) and cerebral fractional tissue oxygen extraction (cFTOE) using near-infrared spectroscopy in 36 very preterm neonates during the first 3 d of life. Simple regression analysis showed a close correlation between left and right rScO2 (r = 0.89, p < 0.01) and cFTOE (r = 0.88, p < 0.01), respectively. The Bland and Altman-determined limits of agreement found overall limits of agreement of -8.5 to +9.5% and of -0.10 to +0.093% between left and right for rScO2 and for cFTOE, respectively. However, we found that during stable systemic oxygenation (i.e., arterial oxygen saturation [SaO2 between 85 and 97%]) the limits of agreement between left and right improved from -7.8 to +8.2% and -0.088 to +0.084 for rScO2 and cFTOE, respectively (all p < 0.05). We conclude that bilateral near-infrared spectroscopy-measured rScO2 and cFTOE can reveal differences up to 10% between left and right hemisphere, especially during unstable arterial saturations, which may indicate uneven cerebral oxygenation.
在一项前瞻性研究中，我们在36例极早产儿出生后的头3天，使用近红外光谱技术同时监测左右顶叶-额叶脑氧饱和度（rScO2）和脑分数组织氧摄取（cFTOE）。简单回归分析显示，左右rScO2（r = 0.89，p < 0.01）和cFTOE（r = 0.88，p < 0.01）之间分别存在密切相关性。Bland和Altman确定的一致性界限发现，rScO2和cFTOE左右之间的总体一致性界限分别为-8.5%至+9.5%和-0.10%至+0.093%。然而，我们发现，在稳定的全身氧合期间（即动脉血氧饱和度[SaO2]在85%至97%之间），rScO2和cFTOE左右之间的一致性界限分别从-7.8%至+8.2%和-0.088%至+0.084%得到改善（所有p < 0.05）。我们得出结论，双侧近红外光谱测量的rScO2和cFTOE可以揭示左右半球之间高达10%的差异，特别是在不稳定的动脉饱和度期间，这可能表明脑氧合不均匀。
