Cardiology, Pediatrics, Advocate Children's Hospital, Oak Lawn, IL, USA.
Medicine, Chicago Medical School/Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Pediatr Cardiol. 2022 Jan;43(1):197-206. doi: 10.1007/s00246-021-02718-7. Epub 2021 Aug 30.
Invasive and non-invasive monitoring allow for early detection of hemodynamic compromise, facilitating timely intervention and avoidance of further decline. While venous oximetry is useful for assessing the adequacy of systemic oxygen delivery (DO), it is most often intermittent, invasive, and costly. Near-infrared spectroscopy (NIRS) oximetry allows for the non-invasive estimation of the adequacy of DO. We assessed the correlation between cerebral NIRS oximetry and superior vena cava (SVC) and jugular venous (JV) oxygen saturations and between renal NIRS oximetry and inferior vena cava (IVC) oxygen saturations. Systematic review of the literature was conducted to identify studies with data regarding near-infrared spectroscopy and venous saturation. The PubMed, EMBASE, Medline, and Cochrane databases were queried using the following terms in isolation and various combinations: "congenital heart disease," "near infrared spectroscopy," "venous saturation," and "pediatric." Pediatric studies in which simultaneous NIRS oximetry and corresponding venous oxygen saturations were simultaneously collected after cardiac surgery or catheterization were identified. Data were pooled from these studies to analyze the correlation between NIRS oximetry and the corresponding venous oxygen saturations. A total of 16 studies with 613 patients were included in the final analyses. Data were present to compare cerebral and renal NIRS oximetry with corresponding venous oxygen saturation. Cerebral NIRS and SVC and JV oxygen saturations and renal NIRS and IVC oxygen saturations demonstrated strong degrees of correlation (r-value 0.70 for each). However, cerebral NIRS and IVC oxygen saturation had a week degree of correlation (r-value of 0.38). Pooled analyses demonstrate that cerebral NIRS oximetry correlates strongly with SVC or JV oxygen saturation while renal NIRS oximetry correlates strongly with IVC oxygen saturations. A weak correlation was noted between cerebral NIRS oximetry and IVC oxygen saturations.
有创和无创监测可早期发现血流动力学障碍,有助于及时干预和避免进一步恶化。静脉血氧饱和度测定虽有助于评估全身氧输送(DO)是否充分,但通常为间断、有创且昂贵。近红外光谱(NIRS)血氧测定可无创估计 DO 是否充分。我们评估了脑 NIRS 血氧测定与上腔静脉(SVC)和颈内静脉(JV)血氧饱和度之间、肾 NIRS 血氧测定与下腔静脉(IVC)血氧饱和度之间的相关性。系统检索文献以确定有 NIRS 和静脉血氧饱和度数据的研究。单独及组合使用以下术语检索 PubMed、EMBASE、Medline 和 Cochrane 数据库:“先天性心脏病”、“近红外光谱”、“静脉血氧饱和度”和“儿科”。识别出心脏手术后或心导管检查后同时采集 NIRS 血氧测定和相应静脉血氧饱和度的儿科研究。汇总这些研究的数据以分析 NIRS 血氧测定与相应静脉血氧饱和度之间的相关性。最终分析纳入了 16 项研究,共 613 例患者。有数据可比较脑和肾 NIRS 血氧测定与相应的静脉血氧饱和度。脑 NIRS 与 SVC 和 JV 血氧饱和度以及肾 NIRS 与 IVC 血氧饱和度具有很强的相关性(r 值分别为 0.70)。但脑 NIRS 与 IVC 血氧饱和度的相关性较弱(r 值为 0.38)。汇总分析表明,脑 NIRS 血氧测定与 SVC 或 JV 血氧饱和度相关性强,而肾 NIRS 血氧测定与 IVC 血氧饱和度相关性强。脑 NIRS 血氧测定与 IVC 血氧饱和度相关性较弱。