Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Caen, France.
J Cardiothorac Vasc Anesth. 2013 Apr;27(2):266-72. doi: 10.1053/j.jvca.2012.04.017. Epub 2012 Jun 9.
Little is known about changes in near-infrared spectroscopy (NIRS)-derived cerebral (rSO(2)b) and somatic (rSO(2)s) oxygen saturation during a fluid challenge. The authors tested the hypothesis that they could differ from central venous oxygen saturation (ScvO(2)) and from one site to another.
A prospective observational study.
A teaching university hospital.
Fifty consecutive adult patients.
Admission to the intensive care unit after cardiac surgery and investigation before and after a fluid challenge.
Simultaneous comparative ScvO(2), rSO(2)b, and rSO(2)s data points were collected from a blood-gas analyzer and the EQUANOX monitor (Nonin Medical, Inc, Plymouth, MN). Correlations were determined by linear regression. Multiple stepwise linear regression models were used to assess independent variables associated with changes in ScvO(2), rSO(2)b, and rSO(2)s. A statistically significant relationship was found between absolute values of ScvO(2) and rSO(2)b (r = 0.42, p < 0.001) but not between absolute values of ScvO(2) and rSO(2)s (r = 0.18, p = 0.066). No relationship was found between percent changes in ScvO(2) and rSO(2)b (r = 0.05, p = 0.715) and between percent changes in ScvO(2) and rSO(2)s (r = 0.02, p = 0.886) after the fluid challenge. Cardiac index contributed to the prediction of changes in ScvO(2) (regression coefficient = -4.09, p = 0.006), whereas the mean arterial pressure contributed to the prediction of changes in rSO(2)b (regression coefficient = -0.05, p = 0.027).
rSO(2)b and rSO(2)s cannot be used to provide noninvasive estimation of ScvO(2), and trends in rSO(2)b and rSO(2)s cannot be considered as noninvasive surrogates for the trend in ScvO(2) after cardiac surgery. Different independent variables contribute to the prediction of ScvO(2), rSO(2)b, and rSO(2)s.
关于在进行液体冲击时，近红外光谱（NIRS）衍生的脑（rSO（2）b）和躯体（rSO（2）s）氧饱和度的变化，人们知之甚少。作者检验了以下假设，即它们可能与中心静脉氧饱和度（ScvO（2））以及不同部位之间存在差异。
前瞻性观察性研究。
教学型大学医院。
连续 50 例成年患者。
心脏手术后入住重症监护病房并在液体冲击前后进行检查。
从血气分析仪和 EQUANOX 监测仪（Nonin Medical，Inc.，明尼苏达州普利茅斯）同时采集 ScvO（2）、rSO（2）b 和 rSO（2）s 的可比数据点。通过线性回归确定相关性。使用多元逐步线性回归模型来评估与 ScvO（2）、rSO（2）b 和 rSO（2）s 变化相关的独立变量。发现 ScvO（2）和 rSO（2）b 的绝对值之间存在统计学显著关系（r = 0.42，p < 0.001），但 ScvO（2）和 rSO（2）s 的绝对值之间没有关系（r = 0.18，p = 0.066）。液体冲击后，ScvO（2）的百分比变化与 rSO（2）b（r = 0.05，p = 0.715）和 ScvO（2）的百分比变化与 rSO（2）s（r = 0.02，p = 0.886）之间没有关系。心指数有助于预测 ScvO（2）的变化（回归系数=-4.09，p = 0.006），而平均动脉压有助于预测 rSO（2）b 的变化（回归系数=-0.05，p = 0.027）。
rSO（2）b 和 rSO（2）s 不能用于无创估计 ScvO（2），并且 rSO（2）b 和 rSO（2）s 的趋势不能被认为是心脏手术后 ScvO（2）趋势的无创替代指标。不同的独立变量有助于预测 ScvO（2）、rSO（2）b 和 rSO（2）s。
