Department of Electrical Engineering (ESAT), Katholieke Universiteit Leuven, and IBBT-KU Leuven Future Health Department, Leuven 3001, Belgium.
Pediatr Res. 2011 Jun;69(6):548-53. doi: 10.1203/PDR.0b013e3182176d85.
The coupling of cerebral intravascular oxygenation (dHbD) with mean arterial blood pressure (MABP) was taken as a reflection of autoregulation assuming constant arterial oxygen content. However, this method is sensitive to movement artifacts. We examined whether the cerebral tissue oxygenation index (cTOI) and regional oxygen saturation (rScO2) may replace dHbD and changes in total Hb (dHbT), respectively. Correlation (COR) and coherence (COH) were used to measure the agreement of MABP with rScO2/dHbT and cTOI/dHbD. dHbD/cTOI and dHbT/rScO2 recordings of, respectively, 34 and 20 preterm infants in need for intensive care were studied during the first days of life. dHbD and cTOI were obtained with the NIRO300 and rScO2 and dHbT with the INVOS4100. Invasive MABP was measured continuously. COR and COH scores of MABP versus dHbD/dHbT were compared with the corresponding ones by replacing dHbD/dHbT by cTOI/rScO2, respectively. Generally, no significant score differences were found for dHbD/cTOI. Differences for dHbT/rScO2 were slightly larger but still within the normal variation of the parameters. Differences become insignificant when restricting calculations to epochs of larger variation in MABP (>10 mm Hg). Hence, we suggest that cTOI and rScO2 can be used to study cerebral autoregulation in newborns.
脑血管血氧饱和度(dHbD)与平均动脉血压(MABP)的耦合被认为是自动调节的反映,假设动脉血氧含量保持不变。然而,这种方法对运动伪影很敏感。我们研究了组织氧合指数(cTOI)和局部氧饱和度(rScO2)是否可以分别替代 dHbD 和总血红蛋白(dHbT)的变化。相关性(COR)和相干性(COH)用于测量 MABP 与 rScO2/dHbT 和 cTOI/dHbD 的一致性。研究了 34 名和 20 名需要重症监护的早产儿在生命的头几天内的 dHbD/cTOI 和 dHbT/rScO2 记录。使用 NIRO300 获得 dHbD 和 cTOI,使用 INVOS4100 获得 rScO2 和 dHbT。连续测量有创性 MABP。将 dHbD/dHbT 分别用 cTOI/rScO2 替代,比较 MABP 与 dHbD/dHbT 的 COR 和 COH 评分与相应评分的差异。一般来说,dHbD/cTOI 没有显著的评分差异。dHbT/rScO2 的差异稍大,但仍在参数的正常变化范围内。当将计算限制在 MABP 变化较大的时段(>10mmHg)时,差异变得不显著。因此,我们建议 cTOI 和 rScO2 可用于研究新生儿的脑自动调节。