Steppan Jochen, Hogue Charles W
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Best Pract Res Clin Anaesthesiol. 2014 Dec;28(4):429-39. doi: 10.1016/j.bpa.2014.09.002. Epub 2014 Sep 28.
The use of near-infrared spectroscopy (NIRS) has been increasingly adopted in cardiac surgery to measure regional cerebral oxygen saturation. This method takes advantage of the fact that light in the near-infrared spectrum penetrates tissue, including bone and muscle. Sensors are placed at fixed distances from a light emitter, and algorithms subtract superficial light absorption from deep absorption to provide an index of tissue oxygenation. Although the popularity of NIRS monitoring is growing, definitive data that prove outcome benefits with its use remain sparse. Therefore, widespread, routine use of NIRS as a standard-of-care monitor cannot be recommended at present. Recent investigations have focused on the use of NIRS in subgroups that may benefit from NIRS monitoring, such as pediatric patients. Furthermore, a novel application of processed NIRS information for monitoring cerebral autoregulation and tissue oxygenation (e.g., kidneys and the gut) is promising.
近红外光谱法(NIRS)在心脏手术中越来越多地被用于测量局部脑氧饱和度。该方法利用了近红外光谱中的光能够穿透包括骨骼和肌肉在内的组织这一事实。传感器被放置在距光发射器固定距离处,算法通过从深层吸收中减去浅表光吸收来提供组织氧合指数。尽管NIRS监测的应用越来越广泛,但证明其使用能带来预后益处的确切数据仍然稀少。因此,目前不建议将NIRS作为标准护理监测手段广泛、常规使用。最近的研究集中在NIRS在可能从NIRS监测中获益的亚组中的应用,如儿科患者。此外,处理后的NIRS信息在监测脑自动调节和组织氧合(如肾脏和肠道)方面的新应用前景广阔。