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血管闭塞试验期间的下肢外周近红外光谱参数:一项针对健康志愿者的实验研究

Lower limb peripheral NIRS parameters during a vascular occlusion test: an experimental study in healthy volunteers.

作者信息

Fellahi J-L, Butin G, Zamparini G, Fischer M-O, Gérard J-L, Hanouz J-L

机构信息

Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Faculty of Medicine EA4650, Université de Caen, 14000 Caen, France.

Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Faculty of Medicine EA4650, Université de Caen, 14000 Caen, France.

出版信息

Ann Fr Anesth Reanim. 2014 Jan;33(1):e9-14. doi: 10.1016/j.annfar.2013.11.014. Epub 2013 Dec 27.

Abstract

OBJECTIVES

The aim of the study was to compare NIRS parameters in combination with a vascular occlusion test (VOT) at a proximal (leg) and a distal (foot) site in male and female.

STUDY DESIGN

A prospective experimental study in healthy subjects.

PATIENTS AND METHODS

Twenty volunteers (10 male, 10 female, 28 ± 4 years) were investigated during 4 experimental steps: baseline, ischemia, reperfusion, and baseline. For each volunteer, 3 NIRS optodes were placed on right and left calves and the left arch of the foot. Blood pressure, heart rate and peripheral pulse oxymetry were monitored.

RESULTS

Significant differences were observed at baseline between regional oxygen saturation (rSO₂) values according to the site of measurement (proximal rSO₂ 81 ± 9% vs distal rSO₂ 60 ± 5%, P<0.001) but not according to gender. Both decreases in proximal and distal rSO₂ during ischemia and increases over baseline values during reperfusion depended on group membership (male or female). NIRS parameters during the VOT were significantly higher in male when compared with female at the proximal site: desaturation rate 5.6% (IQR: 5.5) vs 2.5% (IQR: 0.8), P=0.001; resaturation rate 40.7% (IQR: 6.6) vs 21.7% (IQR: 5.4), P=0.003; and ΔrSO₂ 10.0% (IQR: 7.0) vs 5.5% (IQR: 6.0), P=0.041.

CONCLUSIONS

Values of rSO₂ at the lower limb varied according to the anatomical site of measurement. A VOT induced major changes in rSO₂ that differed between male and female. These results should be taken into account in further clinical studies.

摘要

目的

本研究旨在比较男性和女性在近端(腿部)和远端(足部)部位联合应用近红外光谱(NIRS)参数与血管闭塞试验(VOT)的情况。

研究设计

一项针对健康受试者的前瞻性实验研究。

患者与方法

20名志愿者(10名男性,10名女性,年龄28±4岁)在4个实验阶段接受了调查:基线期、缺血期、再灌注期和基线期。为每位志愿者在左右小腿和左足弓放置3个NIRS光极。监测血压、心率和外周脉搏血氧饱和度。

结果

根据测量部位,基线期区域氧饱和度(rSO₂)值存在显著差异(近端rSO₂为81±9%,远端rSO₂为60±5%,P<0.001),但根据性别无显著差异。缺血期近端和远端rSO₂的降低以及再灌注期高于基线值的增加均取决于分组(男性或女性)。在近端部位,VOT期间男性的NIRS参数显著高于女性:去饱和率5.6%(四分位间距:5.5)对2.5%(四分位间距:0.8),P=0.001;再饱和率40.7%(四分位间距:6.6)对21.7%(四分位间距:5.4),P=0.00!;以及ΔrSO₂ 10.0%(四分位间距:7.0)对5.5%(四分位间距:6.0),P=0.041。

结论

下肢rSO₂值因测量的解剖部位而异。VOT引起的rSO₂主要变化在男性和女性之间存在差异。这些结果在进一步的临床研究中应予以考虑。

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