From the Department of Anaesthesia, Hospital General, Hospital Universitario Virgen del Rocío, Sevilla, Spain (M de la M, AD).
Eur J Anaesthesiol. 2018 May;35(5):365-371. doi: 10.1097/EJA.0000000000000806.
Monitoring regional cerebral oxygen saturation (rcSO2) with near-infrared spectroscopy is increasingly being performed in patients scheduled for cardiac surgery. It is sometimes difficult to monitor both frontal lobes due to anatomical or space compromises. However, it remains unclear whether the use of only one lateral or medial probe can provide adequate bilateral monitoring.
To evaluate the efficacy of using a single lateral or medial probe to detect substantial desaturations on both sides.
A prospective observational study.
Tertiary university teaching hospital.
Seventeen adult patients undergoing elective cardiac surgery monitored with three near-infrared spectroscopy probes (two lateral and one medial) using an INVOS 5100C monitor.
The value of rcSO2 was recorded up to 19 times during each procedure. Substantial desaturation was defined as an absolute rcSO2 value of 50% or less or a decrease of more than 20% compared with baseline values on spontaneous ventilation with 21% oxygen.
The level of agreement between the three pairs of probes using the Bland-Altman method for repeated measures, and the grade of concordant and discordant results between the three pairs of probes by means of contingency tables and the κ coefficient.
We obtained 244 records per probe. Greater agreement was observed between the two lateral probes (mean ± SD of the differences between recordings was -0.9 ± 5.5); mean difference between left and medial, and right and medial probes was 2.4 ± 7.3 and 3.3 ± 6.7, respectively. The rate of discordant results between the two lateral probes was 5.7%, κ coefficient of 0.6 with 95% confidence interval (95% CI 0.4 to 0.8), and between the left and medial, and right and medial of 8.2 and 7.4%, with κ coefficients of 0.57 (95% CI 0.38 to 0.76) and 0.5 (95% CI 0.29 to 0.71), respectively.
In cardiac surgery patients in whom there is difficulty in accommodating two rcSO2 probes, a single lateral probe can effectively measure bilateral rcSO2 in specific scenarios.
近红外光谱仪监测局部脑氧饱和度（rcSO2）在拟行心脏手术的患者中越来越多地应用。由于解剖结构或空间限制，有时难以同时监测两个额叶。然而，目前尚不清楚使用单个外侧或内侧探头是否可以提供足够的双侧监测。
评估使用单个外侧或内侧探头检测双侧显著饱和度降低的效果。
前瞻性观察研究。
三级大学教学医院。
17 例接受择期心脏手术的成年患者，使用 INVOS 5100C 监测仪监测三个近红外光谱探头（两个外侧和一个内侧）。
在每个过程中记录 rcSO2 值多达 19 次。显著饱和度降低定义为绝对 rcSO2 值为 50%或更低，或与 21%氧气自主通气时的基线值相比下降超过 20%。
采用重复测量的 Bland-Altman 方法评估三个探头对之间的一致性水平，以及通过列联表和κ系数评估三个探头对之间的一致性和不一致性结果的等级。
每个探头获得 244 个记录。两个外侧探头之间的一致性更好（记录之间差异的平均值±SD 为-0.9±5.5）；左侧和内侧探头之间以及右侧和内侧探头之间的平均差异分别为 2.4±7.3 和 3.3±6.7。两个外侧探头之间不一致的发生率为 5.7%，κ系数为 0.6，95%置信区间（95%CI 0.4 至 0.8），左侧和内侧以及右侧和内侧探头的发生率分别为 8.2%和 7.4%，κ系数分别为 0.57（95%CI 0.38 至 0.76）和 0.5（95%CI 0.29 至 0.71）。
在难以适应两个 rcSO2 探头的心脏手术患者中，在特定情况下，单个外侧探头可有效测量双侧 rcSO2。
