Division of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3032, USA.
J Surg Res. 2011 Nov;171(1):159-63. doi: 10.1016/j.jss.2009.11.012. Epub 2009 Nov 29.
Near-infrared spectroscopy (NIRS) has been shown to provide reliable noninvasive monitoring of regional oxygenation in a variety of clinical settings. We set out to test its feasibility as a monitor of fetal and placental oxygenation during fetal cardiac surgery.
Six ovine fetuses from 98-110 ds gestation were placed on fetal bypass for 30 min and followed post-bypass for 2 h. A NIRS probe (MI INVOS 5100B; Somanetics, Troy, MI) was placed on the pregnant uterine horn during and after fetal surgery. NIRS values were compared with blood gas values obtained by direct sampling from umbilical circulation.
NIRS values positively correlated with umbilical venous oxygen saturation (R(2)=0.891, P<0.01) and partial oxygen pressure values (R(2)=0.810, P<0.01). NIRS values also correlated to a lesser extent with umbilical venous pH and pCO(2), and fetal arterial pH, pO(2), and oxygen saturation.
This is the first report of application of NIRS in the setting of fetal surgery. NIRS permits noninvasive assessment of placental oxygen saturation and pO(2). This technology is a simple and useful tool for real-time monitoring of oxygen delivery to the fetus during maternal-fetal cardiac interventions and of overall well-being of the fetal-placental unit.
近红外光谱（NIRS）已被证明可在多种临床环境中提供可靠的局部氧合的非侵入性监测。我们着手测试其在胎儿心脏手术期间监测胎儿和胎盘氧合的可行性。
6 只来自 98-110 天孕期的绵羊胎儿接受胎儿体外循环 30 分钟，并在体外循环后 2 小时内进行后续监测。在胎儿手术期间和之后，将 NIRS 探头（MI INVOS 5100B；Somanetics，Troy，MI）放置在孕妇子宫角上。NIRS 值与通过直接从脐循环取样获得的血气值进行比较。
NIRS 值与脐静脉血氧饱和度（R(2)=0.891，P<0.01）和部分氧分压值（R(2)=0.810，P<0.01）呈正相关。NIRS 值与脐静脉 pH 值和 pCO(2)、胎儿动脉 pH 值、pO(2)和氧饱和度也有一定程度的相关性。
这是 NIRS 在胎儿手术环境中应用的首次报告。NIRS 允许对胎盘氧饱和度和 pO(2)进行非侵入性评估。这项技术是一种简单而有用的工具，可用于在母体-胎儿心脏干预期间实时监测胎儿的氧气输送，并监测胎儿-胎盘单位的整体健康状况。
