Tume Lyvonne N, Arnold Philip
1Department of PICU,Alder Hey Children's NHS Foundation Trust and Department,Liverpool,United Kingdom.
3Department of Translational Medicine,Alder Hey Children's NHS Foundation Trust,University of Liverpool,Liverpool,United Kingdom.
Cardiol Young. 2015 Mar;25(3):459-67. doi: 10.1017/S1047951114000055. Epub 2014 Feb 13.
To establish whether the use of near-infrared spectroscopy is potentially beneficial in high-risk cardiac infants in United Kingdom paediatric intensive care units.
A prospective observational pilot study.
An intensive care unit in North West England.
A total of 10 infants after congenital heart surgery, five with biventricular repairs and five with single-ventricle physiology undergoing palliation.
Cerebral and somatic near-infrared spectroscopy monitoring for 24 hours post-operatively in the intensive care unit.
Overall, there was no strong correlation between cerebral near-infrared spectroscopy and mixed venous oxygen saturation (r=0.48). At individual time points, the correlation was only strong (r=0.74) 1 hour after admission. The correlation was stronger for the biventricular patients (r=0.68) than single-ventricle infants (r=0.31). A strong inverse correlation was demonstrated between cerebral near-infrared spectroscopy and serum lactate at 3 of the 5 post-operative time points (1, 4, and 12 hours: r=-0.76, -0.72, and -0.69). The correlation was stronger when the cerebral near-infrared spectroscopy was <60%. For cerebral near-infrared spectroscopy <60%, the inverse correlation with lactate was r=-0.82 compared with those cerebral near-infrared spectroscopy >60%, which was r=-0.50. No correlations could be demonstrated between (average) somatic near-infrared spectroscopy and serum lactate (r=-0.13, n=110) or mixed venous oxygen saturation and serum lactate. There was one infant who suffered a cardiopulmonary arrest, and the cerebral near-infrared spectroscopy showed a consistent 43 minute decline before the event.
We found that cerebral near-infrared spectroscopy is potentially beneficial as a non-invasive, continuously displayed value and is feasible to use on cost-constrained (National Health Service) cardiac intensive care units in children following heart surgery.
确定近红外光谱技术在英国儿科重症监护病房高危心脏疾病患儿中的应用是否具有潜在益处。
一项前瞻性观察性试点研究。
英格兰西北部的一家重症监护病房。
共10例先天性心脏病手术后的婴儿，其中5例接受双心室修复，5例单心室生理状态患儿接受姑息治疗。
在重症监护病房术后24小时进行脑和躯体近红外光谱监测。
总体而言，脑近红外光谱与混合静脉血氧饱和度之间无强相关性（r = 0.48）。在各个时间点，仅入院1小时后相关性较强（r = 0.74）。双心室修复患儿的相关性（r = 0.68）强于单心室患儿（r = 0.31）。在术后5个时间点中的3个（1小时、4小时和12小时：r = -0.76、-0.72和-0.69），脑近红外光谱与血清乳酸呈强负相关。当脑近红外光谱<60%时相关性更强。对于脑近红外光谱<60%，与乳酸的负相关系数r = -0.82，而脑近红外光谱>60%时，r = -0.50。（平均）躯体近红外光谱与血清乳酸（r = -0.13，n = 孔）或混合静脉血氧饱和度与血清乳酸之间未显示相关性。有1例婴儿发生心肺骤停，事件发生前脑近红外光谱持续下降43分钟。
我们发现脑近红外光谱作为一种无创、持续显示的值具有潜在益处，并且在成本受限的（国民医疗服务体系）儿童心脏重症监护病房中使用是可行的，这些患儿均接受过心脏手术。
