Kobayashi Kensuke, Kitamura Tadashi, Kohira Satoshi, Torii Shinzo, Mishima Toshiaki, Ohkubo Hirotoki, Tanaka Yuki, Sasahara Akihiro, Fukunishi Takuma, Ohtomo Yuki, Horikoshi Rihito, Murai Yuta, Miyaji Kagami
Department of Cardiovascular Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan.
Department of Medical Engineering, Kitasato University Hospital, Sagamihara, Japan.
J Artif Organs. 2018 Dec;21(4):412-418. doi: 10.1007/s10047-018-1052-3. Epub 2018 Jun 20.
Regional cerebral oximetry using near-infrared spectroscopy devices is commonly used for detecting cerebral ischemia during cardiopulmonary bypass, and aim to avoid poor cerebral perfusion which may result in perioperative neurological impairment. Today, several devices that can detect cerebral ischemia are commercially available. Although these devices operate on the same measurement principles, their algorithms for detecting and calculating cerebral ischemia are different and no criteria for directly comparing values measured by such different devices exist. From January 2017 to August 2017, 80 adult cardiovascular surgery patients were enrolled in the prospective study. In each patient, preoperative regional cerebral oxygen saturation values were measured by two different devices and their correlations with various preoperative factors were evaluated. Regional cerebral oxygen saturation levels were significantly higher for values of FORE-SIGHT ELITE (CAS Medical Systems, Branford, CT, USA) (F value) than those of the INVOS 5100C (Medtronic, Minneapolis, MN, USA) (I value). Scalp-cortex distance, hemoglobin concentration, and the presence or absence of hemodialysis showed significant correlations with ratios of measured values specific to each device (F/I). An appropriate device should be selected according to preoperative patient characteristics, and factors influencing regional cerebral oxygen saturation values should be considered to ensure the correct interpretation of measured values. This research was conducted with the approval of the ethics committee of our university (approval number: B16-96).
使用近红外光谱设备的局部脑血氧饱和度测定法常用于在体外循环期间检测脑缺血，并旨在避免可能导致围手术期神经损伤的脑灌注不足。如今，有几种能够检测脑缺血的设备已在市场上销售。尽管这些设备基于相同的测量原理运行，但其检测和计算脑缺血的算法不同，并且不存在直接比较此类不同设备所测值的标准。在2017年1月至2017年8月期间，80名成年心血管手术患者被纳入前瞻性研究。对每名患者使用两种不同设备测量术前局部脑氧饱和度值，并评估其与各种术前因素的相关性。与美国明尼阿波利斯美敦力公司的INVOS 5100C（I值）相比，美国康涅狄格州布兰福德CAS医疗系统公司的FORE-SIGHT ELITE（F值）所测的局部脑氧饱和度水平显著更高。头皮-皮层距离、血红蛋白浓度以及是否进行血液透析与每种设备特定测量值的比率（F/I）显示出显著相关性。应根据术前患者特征选择合适的设备，并应考虑影响局部脑氧饱和度值的因素，以确保对测量值的正确解读。本研究在获得我校伦理委员会批准（批准号：B16-96）的情况下进行。
