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联合使用 tNIRS-1 和脑电双频指数监测心脏手术患者脑组织氧饱和度的有效方法。

Effective method of monitoring cerebral tissue oxygen saturation in cardiac surgery patients by combined use of tNIRS-1 and bispectral index.

机构信息

Department of Clinical Engineering, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-chuo, Tsuzuki ward, Yokohama city, Kanagawa, 224-8503, Japan.

出版信息

Sci Rep. 2021 Dec 16;11(1):24126. doi: 10.1038/s41598-021-03527-x.

Abstract

To continuously and noninvasively monitor the cerebral tissue oxygen saturation (StO) and hemoglobin concentration (gasHb) in cardiac surgery patients, a method combining the use of a cerebral tissue oximeter using near infrared time-resolved spectroscopy (tNIRS-1) and the bispectral index (BIS) was developed in this study. Moreover, the correlation between the estimated hemoglobin concentration (estHb), measured via tNIRS-1, and the hemoglobin concentration (gasHb), analyzed using a blood gas analyzer, were compared. The relationship between the BIS and gasHb was also examined. Through the comparison of BIS and StO (r1), and estHb and gasHb (r2), the correlation between the two was clarified with maximum r1 and r2 values of 0.617 and 0.946, respectively. The relationship between BIS and gasHb (r3), showed that there was a favorable correlation with a maximum r3 value of 0.969. There was also a continuous correlation between BIS and StO in patients undergoing cardiac surgery. In addition, a strong correlation was found between estHb and gasHb, and between BIS and gasHb. It was therefore concluded that the combined use of BIS and tNIRS-1 is useful to evaluate cerebral hypoxia, allowing for quick response to cerebral hypoxia and reduction of hemoglobin concentration during the operation.

摘要

为了连续、无创地监测心脏手术患者的脑血氧饱和度 (StO) 和血红蛋白浓度 (gasHb),本研究提出了一种将近红外时间分辨光谱 (tNIRS-1) 脑氧饱和度仪与双频谱指数 (BIS) 相结合的方法。此外,还比较了通过 tNIRS-1 测量的估计血红蛋白浓度 (estHb) 与血气分析仪分析的血红蛋白浓度 (gasHb) 之间的相关性。还检查了 BIS 和 gasHb 之间的关系。通过比较 BIS 和 StO(r1),以及 estHb 和 gasHb(r2),分别得出了 r1 和 r2 的最大 值为 0.617 和 0.946,从而明确了两者之间的相关性。BIS 和 gasHb(r3)之间的关系表明,最大 r3 值为 0.969,存在良好的相关性。心脏手术患者的 BIS 和 StO 之间也存在连续相关性。此外,还发现 estHb 和 gasHb 之间以及 BIS 和 gasHb 之间存在强相关性。因此,得出结论,BIS 和 tNIRS-1 的联合使用有助于评估脑缺氧,并能够在手术过程中快速响应脑缺氧和血红蛋白浓度降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b3b/8677723/f55264346d0e/41598_2021_3527_Fig1_HTML.jpg

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