Drayna Patrick C, Abramo Thomas J, Estrada Cristina
Emergency Medicine and Pediatrics, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Pediatr Emerg Care. 2011 May;27(5):432-9; quiz 440-2. doi: 10.1097/PEC.0b013e3182188442.
Near-infrared spectroscopy is a noninvasive means of determining real-time changes in regional oxygen saturation of cerebral and somatic tissues. Hypoxic neurologic injuries not only involve devastating effects on patients and their families but also increase health care costs to the society. At present, monitors of cerebral function such as electroencephalograms, transcranial Doppler, jugular bulb mixed venous oximetry, and brain tissue oxygenation monitoring involve an invasive procedure, are operator-dependent, and/or lack the sensitivity required to identify patients at risk for cerebral hypoxia. Although 20th century advances in the understanding and management of resuscitation of critically ill and injured children have focused on global parameters (ie, pulse oximetry, capnography, base deficit, lactate, etc), a growing body of evidence now points to regional disturbances in microcirculation that will lead us in a new direction of adjunctive tissue monitoring and response to resuscitation. In the coming years, near-infrared spectroscopy will be accepted as a way for clinicians to more quickly and noninvasively identify patients with altered levels of cerebral and/or somatic tissue oxygenation and, in conjunction with global physiologic parameters, guide efficient and effective resuscitation to improve outcomes for critically ill and injured pediatric patients.
近红外光谱法是一种用于确定脑和躯体组织局部氧饱和度实时变化的非侵入性方法。缺氧性神经损伤不仅会给患者及其家庭带来毁灭性影响，还会增加社会的医疗成本。目前，诸如脑电图、经颅多普勒、颈静脉球混合静脉血氧饱和度测定以及脑组织氧合监测等脑功能监测方法都涉及侵入性操作，依赖操作人员，并且/或者缺乏识别脑缺氧风险患者所需的敏感性。尽管20世纪在危重症和受伤儿童复苏的理解和管理方面取得了进展，重点关注全局参数（如脉搏血氧饱和度、二氧化碳图、碱缺失、乳酸等），但越来越多的证据表明微循环存在局部紊乱，这将引领我们朝着辅助组织监测和复苏反应的新方向发展。在未来几年，近红外光谱法将被临床医生接受，作为一种更快速、非侵入性地识别脑和/或躯体组织氧合水平改变患者的方法，并结合全局生理参数，指导高效有效的复苏，以改善危重症和受伤儿科患者的治疗效果。
