Department of Pediatrics, University Medical Centre, 9700 RB Groningen, The Netherlands.
Pediatr Res. 2011 Oct;70(4):389-94. doi: 10.1203/PDR.0b013e31822a36db.
Near-infrared spectroscopy is a noninvasive method for monitoring brain oxygenation. The aim of the study was to investigate differences between cerebral oxygenation in different brain regions in newborns. In a prospective study, we monitored simultaneously left and right frontoparietal and temporo-occipital regional cerebral oxygen saturation (rScO2) and cerebral fractional tissue extraction (cFTOE: (arterial oxygen saturation (SaO2) - rScO2)/SaO2) using near-infrared spectroscopy. A 2-h measurement was performed on d 1, 3, and 7. We included 10 very preterm (GA <32 wk), 10 preterm (GA: 32-37 wk), and 10 term (GA ≥37 wk) neonates. Limits of agreement for difference of the measurements between different places were determined using the Bland-Altman method. In all subgroups, the rScO2 and cFTOE values at different regions were not different. Limits of agreement were between ±14 and ±18% for all subgroups. Left-to-right differences were small between different postnatal and GAs. A decrease and increase over time for rScO2 and cFTOE values was detected for all four brain regions, most pronounced for infants with GA <32 wk. Cerebral oxygenation in stable preterm and term neonates seems not to differ between different regions of the brain during the early neonatal period. However, variability of individual measurements was quite high as indicated by large limits of agreement.
近红外光谱是一种监测脑氧合的非侵入性方法。本研究旨在探讨新生儿不同脑区脑氧合的差异。采用前瞻性研究，我们使用近红外光谱同时监测左、右侧额顶叶和颞枕叶区域脑氧饱和度(rScO2)和脑局部组织氧摄取分数(cFTOE：(动脉氧饱和度(SaO2)-rScO2)/SaO2)。在第 1、3 和 7 天进行 2 小时测量。共纳入 10 例极早产儿(GA<32 周)、10 例早产儿(GA：32-37 周)和 10 例足月儿(GA≥37 周)。采用 Bland-Altman 法确定不同部位测量值差值的一致性界限。在所有亚组中，不同部位的 rScO2 和 cFTOE 值均无差异。所有亚组的一致性界限均为±14%和±18%。不同出生后和 GA 之间的左右差异较小。所有四个脑区的 rScO2 和 cFTOE 值随时间呈下降和上升趋势，GA<32 周的婴儿最为明显。在新生儿早期，稳定的早产儿和足月儿的脑氧合似乎在不同脑区之间没有差异。然而，个体测量值的变异性相当高，这表明一致性界限较大。
