Ranucci Marco, Isgrò Giuseppe, De la Torre Teresa, Romitti Federica, Conti Daniela, Carlucci Concetta
Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico S.Donato, Milan, Italy.
Paediatr Anaesth. 2008 Dec;18(12):1163-9. doi: 10.1111/j.1460-9592.2008.02783.x.
Cerebral regional oxygen saturation (rSO(2)) measured with near-infrared spectroscopy (NIRS) has a well-proven clinical utility. A goal-oriented treatment based on the rSO(2) resulted in a significant reduction in major morbidity and in a shortening of postoperative hospital stay in patients undergoing coronary revascularization. In this study, we have compared the values of superior vena cava saturation (ScvO(2)) continuously measured with a Pediasat catheter and the corresponding NIRS rSO(2) values obtained during cardiac operations in pediatric patients.
This was a prospective observational study enrolling fifteen pediatric patients (age: 6 days-7 years) undergoing cardiac operations. ScvO(2) data obtained with the Pediasat during the operation were compared with simultaneously recorded NIRS rSO(2) values.
One hundred and seventeen matched sets of data were obtained during the operation. ScvO(2) continuously measured with the Pediasat was significantly correlated with the corresponding NIRS rSO(2) values. However, there was a constant positive bias (ScvO(2) values were higher than NIRS rSO(2) values) of 5.6%, with a precision of 10.4%. Time-related percentage changes of NIRS rSO(2) were significantly correlated with the corresponding ScvO(2) percentage changes. A decrease in ScvO(2) is predictive for a decrease in rSO(2) with a sensitivity of 73.7% and a specificity of 85.7%.
The continuous measurement of ScvO(2) values obtained by the Pediasat may provide useful information about the metabolic conditions of the brain during cardiac operations in pediatric patients if considered as percentage changes. Absolute values of ScvO(2) tend to overestimate the correspondent rSO(2) values.
用近红外光谱法（NIRS）测量的脑局部氧饱和度（rSO₂）具有充分证实的临床效用。基于rSO₂的目标导向治疗显著降低了接受冠状动脉血运重建术患者的主要发病率，并缩短了术后住院时间。在本研究中，我们比较了使用Pediasat导管连续测量的上腔静脉饱和度（ScvO₂）值与小儿心脏手术期间获得的相应NIRS rSO₂值。
这是一项纳入15例接受心脏手术的小儿患者（年龄：6天至7岁）的前瞻性观察研究。将手术期间用Pediasat获得的ScvO₂数据与同时记录的NIRS rSO₂值进行比较。
手术期间获得了117组匹配数据。用Pediasat连续测量的ScvO₂与相应的NIRS rSO₂值显著相关。然而，存在5.6%的恒定正偏差（ScvO₂值高于NIRS rSO₂值），精确度为10.4%。NIRS rSO₂的时间相关百分比变化与相应的ScvO₂百分比变化显著相关。ScvO₂降低可预测rSO₂降低，敏感性为73.7%，特异性为85.7%。
如果将Pediasat获得的ScvO₂值视为百分比变化，其连续测量可为小儿心脏手术期间大脑的代谢状况提供有用信息。ScvO₂的绝对值往往高估相应的rSO₂值。
