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心脏麻醉中的脑氧饱和度监测

Cerebral oximetry in cardiac anesthesia.

作者信息

Vretzakis George, Georgopoulou Stauroula, Stamoulis Konstantinos, Stamatiou Georgia, Tsakiridis Kosmas, Zarogoulidis Paul, Katsikogianis Nikolaos, Kougioumtzi Ioanna, Machairiotis Nikolaos, Tsiouda Theodora, Mpakas Andreas, Beleveslis Thomas, Koletas Alexander, Siminelakis Stavros N, Zarogoulidis Konstantinos

机构信息

1 Anesthesiology Clinic, University Hospital of Larissa, Greece ; 2 Anesthesiology Department, University Hospital of Larisa, Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 9 Cardiothoracic Surgery Department, University Hospital of Ioannina, Ioannina, Greece.

出版信息

J Thorac Dis. 2014 Mar;6 Suppl 1(Suppl 1):S60-9. doi: 10.3978/j.issn.2072-1439.2013.10.22.

DOI:10.3978/j.issn.2072-1439.2013.10.22
PMID:24672700
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3966165/
Abstract

Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively according their risk. Intraoperatively, it provides continuous information about brain oxygenation and allows the use of brain as sentinel organ indexing overall organ perfusion and injury. This review focuses on the clinical validity and applicability of this monitor for cardiac surgical patients.

摘要

基于近红外光谱技术(NIRS)的脑氧饱和度监测在心血管手术围术期的应用日益广泛。它是一种无创技术,可监测额叶皮质的局部氧饱和度。目前的文献表明,它可以在术前根据患者风险进行分层。在术中,它能提供有关脑氧合的连续信息,并允许将脑作为指示整体器官灌注和损伤的哨兵器官。本综述重点关注该监测仪在心脏手术患者中的临床有效性和适用性。

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本文引用的文献

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Monitoring of brain oxygen saturation (INVOS) in a protocol to direct blood transfusions during cardiac surgery: a prospective randomized clinical trial.在心脏手术期间指导输血方案中监测脑氧饱和度(INVOS):一项前瞻性随机临床试验。
J Cardiothorac Surg. 2013 Jun 7;8:145. doi: 10.1186/1749-8090-8-145.
2
Con: near-infrared spectroscopy has not proven its clinical utility as a standard monitor in cardiac surgery.反对观点:近红外光谱法尚未证明其作为心脏手术标准监测手段的临床效用。
J Cardiothorac Vasc Anesth. 2013 Apr;27(2):390-4. doi: 10.1053/j.jvca.2012.11.010.
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PLoS One. 2013;8(2):e57881. doi: 10.1371/journal.pone.0057881. Epub 2013 Feb 28.
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Anesth Analg. 2013 Mar;116(3):663-76. doi: 10.1213/ANE.0b013e318277a255. Epub 2012 Dec 24.
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Cerebral perfusion pressure, microdialysis biochemistry and clinical outcome in patients with traumatic brain injury.创伤性脑损伤患者的脑灌注压、微透析生物化学与临床结局
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Non-invasive cerebral oxygenation reflects mixed venous oxygen saturation during the varying haemodynamic conditions in patients undergoing transapical transcatheter aortic valve implantation.在经心尖经导管主动脉瓣植入术患者不同血流动力学状态下,无创性脑氧合反映混合静脉血氧饱和度。
Interact Cardiovasc Thorac Surg. 2012 Mar;14(3):268-72. doi: 10.1093/icvts/ivr102. Epub 2011 Dec 7.
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Minerva Anestesiol. 2011 Oct;77(10):952-8.
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Preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on-pump cardiac surgery patients: a prospective observational trial.术中区域脑氧饱和度是体外循环心脏手术患者术后谵妄的预测指标:一项前瞻性观察性试验。
Crit Care. 2011;15(5):R218. doi: 10.1186/cc10454. Epub 2011 Sep 19.
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Near infrared spectroscopy describes physiologic payback associated with excess postexercise oxygen consumption in healthy controls and children with complex congenital heart disease.近红外光谱法描述了健康对照组和患有复杂先天性心脏病的儿童运动后过量耗氧量相关的生理恢复情况。
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