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早产儿出生后前3天局部脑氧饱和度的参考值。

Reference values of regional cerebral oxygen saturation during the first 3 days of life in preterm neonates.

作者信息

Alderliesten Thomas, Dix Laura, Baerts Wim, Caicedo Alexander, van Huffel Sabine, Naulaers Gunnar, Groenendaal Floris, van Bel Frank, Lemmers Petra

机构信息

Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands.

Department of Electrical Engineering (ESAT), Division SCD, KU Leuven, Leuven, Belgium.

出版信息

Pediatr Res. 2016 Jan;79(1-1):55-64. doi: 10.1038/pr.2015.186. Epub 2015 Sep 21.

Abstract

BACKGROUND

Currently, reliable reference values of regional cerebral oxygen saturation (rScO2) for different gestational age (GA) groups are lacking, which hampers the implementation of near-infrared spectroscopy (NIRS) alongside monitoring arterial oxygen saturation (SaO2) and blood pressure in neonatal intensive care. The aim of this study was to provide reference values for rScO2 and cerebral fractional tissue oxygen extraction (cFTOE; (SaO2 - rScO2)/SaO2) for small adult and neonatal NIRS sensors.

METHODS

In this study, 999 infants born preterm (GA <32 wk) were monitored with NIRS during the first 72 h of life. Mixed modeling was used to generate reference curves grouped per 2 wk of GA. In addition, the influence of a hemodynamically significant patent ductus arteriosus, gender, and birth weight were explored.

RESULTS

Average rScO2 was ~65% at admission, increased with GA (1% per week) and followed a parabolic curve in relation to postnatal age with a peak at ~36 h. The cFTOE showed similar but inverse effects. On average, the neonatal sensor measured 10% higher than the adult sensor.

CONCLUSION

rScO2 and cFTOE reference curves are provided for the first 72 h of life in preterm infants, which might support the broader implementation of NIRS in neonatal intensive care.

摘要

背景

目前,不同胎龄(GA)组的局部脑氧饱和度(rScO2)缺乏可靠的参考值,这阻碍了在新生儿重症监护中同时监测动脉血氧饱和度(SaO2)和血压时近红外光谱(NIRS)的应用。本研究的目的是为小型成人和新生儿NIRS传感器提供rScO2和脑分数组织氧摄取率(cFTOE;(SaO2 - rScO2)/SaO2)的参考值。

方法

在本研究中,对999例早产(GA<32周)婴儿在出生后72小时内进行了NIRS监测。采用混合模型生成每2周GA分组的参考曲线。此外,还探讨了血流动力学上显著的动脉导管未闭、性别和出生体重的影响。

结果

入院时平均rScO2约为65%,随GA增加(每周1%),并与出生后年龄呈抛物线关系,在约36小时达到峰值。cFTOE显示出类似但相反的效应。平均而言,新生儿传感器的测量值比成人传感器高10%。

结论

提供了早产儿出生后72小时内的rScO2和cFTOE参考曲线,这可能有助于NIRS在新生儿重症监护中的更广泛应用。

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