Division of Pediatric Cardiothoracic Surgery, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA.
J Thorac Cardiovasc Surg. 2011 Aug;142(2):359-65. doi: 10.1016/j.jtcvs.2010.12.021.
Cerebral and flank near-infrared spectroscopy are used to monitor tissue oxygenation during cardiopulmonary bypass in pediatric patients. We sought to validate these noninvasive measurements as predictors of oxygen saturation in the superior and inferior venae cavae during cardiopulmonary bypass.
Eight patients underwent elective repair of congenital heart defects with bicaval cannulation. Ultrasonic flow probes and oximetric catheters were placed in the superior and inferior venae cavae limbs of the perfusion circuit. Cerebral and flank near-infrared spectroscopy and 12 additional variables were recorded each minute on cardiopulmonary bypass. Relationships between these variables and superior and inferior venae cavae oxygen saturation were analyzed by linear mixed modeling. The regression of superior vena cava oxygen saturation by current cerebral near-infrared spectroscopy and 1-minute lag cerebral near-infrared spectroscopy, which are equivalent to the regression of the superior vena cava saturation by the current cerebral near-infrared spectroscopy and the 1-minute change in cerebral near-infrared spectroscopy, were used to assess cerebral near-infrared spectroscopy as a trend monitor.
The mean number of observation time points per patient was 86 (median 72, range 34-194) for 690 total observations. The root mean square percentage error was 6.39% for the prediction model of superior vena cava saturation by single-factor cerebral near-infrared spectroscopy. The root mean square percentage error was 10.8% for the prediction model of inferior vena cava saturation by single-factor flank near-infrared spectroscopy.
Cerebral near-infrared spectroscopy accurately predicts superior vena cava oxygen saturation and changes in superior vena cava oxygen saturation on cardiopulmonary bypass. The relationship between flank near-infrared spectroscopy and inferior vena cava saturation is not as strong.
脑和侧腹部近红外光谱用于监测心肺旁路术期间儿科患者的组织氧合。我们试图验证这些非侵入性测量值作为心肺旁路术期间上下腔静脉血氧饱和度的预测指标。
8 名患者接受双侧腔静脉插管择期修复先天性心脏缺陷。在灌注回路的上下腔静脉肢体中放置超声流量探头和血氧定量导管。在心肺旁路术期间，每分钟记录脑和侧腹部近红外光谱和其他 12 个变量。通过线性混合建模分析这些变量与上下腔静脉血氧饱和度之间的关系。通过当前脑近红外光谱和 1 分钟滞后脑近红外光谱对上腔静脉氧饱和度的回归，这相当于当前脑近红外光谱对上腔静脉饱和度的回归和脑近红外光谱的 1 分钟变化，用于评估脑近红外光谱作为趋势监测。
每位患者的平均观察时间点为 86 个（中位数 72 个，范围 34-194 个），共 690 个总观察点。单一因素脑近红外光谱对上腔静脉饱和度预测模型的均方根百分比误差为 6.39%。单一因素侧腹部近红外光谱对下腔静脉饱和度的预测模型的均方根百分比误差为 10.8%。
脑近红外光谱准确预测心肺旁路术期间上腔静脉氧饱和度和上腔静脉氧饱和度的变化。侧腹部近红外光谱与下腔静脉饱和度之间的关系不那么强。
