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近红外光谱法测量呼吸窘迫综合征早产儿的肺氧合:一项概念验证研究。

Measurement of lung oxygenation by near-infrared spectroscopy in preterm infants with respiratory distress syndrome: A proof-of-concept study.

作者信息

Dani Carlo, Ciarcià Martina, Miselli Francesca, Luzzati Michele, Petrolini Chiara, Corsini Iuri, Simone Pratesi

机构信息

Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.

Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy.

出版信息

Pediatr Pulmonol. 2022 Oct;57(10):2306-2312. doi: 10.1002/ppul.25824. Epub 2022 Aug 23.

Abstract

INTRODUCTION

Noninvasive markers more accurate than FiO would be useful to assess the severity of RDS and guide its treatment. Our aim was to assess for the first time the possibility of continuously monitoring lung oxygenation (rSO L) by near-infrared spectroscopy (NIRS) and to evaluate whether rSO L correlates with other oxygenation indices and RDS severity.

METHODS

We carried out this proof-of-concept study on 20 preterm infants with RDS requiring noninvasive respiratory support. Patients were continuously studied for 24 h by NIRS and rSO L was correlated with SpO /FiO ratio, a/APO , and O.I.

RESULTS

The overall value of rSO L was 80.1 ± 6.2%, without significant differences between the right and left hemithorax (80.2 ± 6.7 vs. 80.0 ± 5.7%; p = 0.869). Mean values of total, right, and left rSO L did not significantly change during the 24-h study period. Linear regression analysis demonstrated a significant positive relationship between total rSO L and SpO /FiO ratio (p < 0.001) and a/APO (p = 0.040), and a negative relationship between total rSO L and O.I. (r = -0.309; p = 0.022).

CONCLUSIONS

Continuous monitoring of rSO L by NIRS in preterm infants with RDS is feasible and safe. The correlation of rSO L with other indices of oxygenation and RDS severity supports the accuracy and reliability of this measurement.

摘要

引言

比吸入氧分数(FiO₂)更准确的无创标志物对于评估呼吸窘迫综合征(RDS)的严重程度及指导其治疗将很有用。我们的目的是首次评估通过近红外光谱(NIRS)连续监测肺氧合(rSO₂L)的可能性,并评估rSO₂L是否与其他氧合指标及RDS严重程度相关。

方法

我们对20例需要无创呼吸支持的RDS早产儿进行了这项概念验证研究。通过NIRS对患者进行24小时连续研究,并将rSO₂L与经皮血氧饱和度(SpO₂)/FiO₂比值、肺泡动脉氧分压差(a/APO₂)和氧合指数(OI)进行相关性分析。

结果

rSO₂L的总体值为80.1±6.2%,左右半胸之间无显著差异(80.2±6.7%对80.0±5.7%;p = 0.869)。在24小时研究期间,总rSO₂L、右侧rSO₂L和左侧rSO₂L的平均值无显著变化。线性回归分析显示总rSO₂L与SpO₂/FiO₂比值(p < 0.001)和a/APO₂(p = 0.040)之间存在显著正相关,总rSO₂L与OI之间存在负相关(r = -0.309;p = 0.022)。

结论

在患有RDS的早产儿中通过NIRS连续监测rSO₂L是可行且安全的。rSO₂L与其他氧合指标及RDS严重程度的相关性支持了该测量的准确性和可靠性。

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