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小儿心脏手术体外循环期间平均动脉压与局部脑氧饱和度的相关性

Correlation between Mean Arterial Pressure and Regional Cerebral Oxygen Saturation on Cardiopulmonary Bypass in Pediatric Cardiac Surgery.

作者信息

Pan Yu, Song Qingqing, Kanazawa Tomoyuki, Morimatsu Hiroshi

机构信息

Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

出版信息

Acta Med Okayama. 2022 Oct;76(5):557-564. doi: 10.18926/AMO/64037.

Abstract

Some pediatric cardiac patients might experience low regional cerebral oxygen saturation (rSO2) during surgery. We investigated whether a pediatric patient's mean arterial pressure (MAP) can affect the rSO2 value during cardiopulmonary bypass (CPB). We retrospectively analyzed the cases of the pediatric patients who underwentcardiac surgery at our hospital (Jan. -Dec. 2019; n=141). At each MAP stage, we constructed line charts through the mean of the rSO2 values corresponding to each MAP and then calculated the correlation coefficients. We next divided the patients into age subgroups (neonates, infants, children) and into cyanotic congenital heart disease (CHD) and acyanotic CHD groups and analyzed these groups in the same way. The analyses of all 141 patients revealed that during CPB the rSO2 value increased with an increase in MAP (r=0.1626). There was a correlation between rSO2 and MAP in the children (r=0.2720) but not in the neonates (r=0.06626) or infants (r=0.05260). Cyanotic CHD or acyanotic CHD did not have a significant effect on the rSO2/MAP correlation. Our analysis demonstrated different patterns of a correlation between MAP and rSO2 in pediatric cardiac surgery patients, depending on age. MAP was positively correlated with rSO2 typically in children but not in neonate or infant patients.

摘要

一些小儿心脏病患者在手术过程中可能会出现局部脑氧饱和度(rSO2)降低的情况。我们研究了小儿患者的平均动脉压(MAP)是否会影响体外循环(CPB)期间的rSO2值。我们回顾性分析了我院2019年1月至12月接受心脏手术的小儿患者病例(n = 141)。在每个MAP阶段,我们通过对应于每个MAP的rSO2值的平均值构建折线图,然后计算相关系数。接下来,我们将患者分为年龄亚组(新生儿、婴儿、儿童)以及青紫型先天性心脏病(CHD)和非青紫型CHD组,并以同样的方式进行分析。对所有141例患者的分析显示,在CPB期间,rSO2值随MAP升高而增加(r = 0.1626)。儿童中rSO2与MAP之间存在相关性(r = 0.2720),但新生儿(r = 0.06626)和婴儿(r = 0.05260)中不存在这种相关性。青紫型CHD或非青紫型CHD对rSO2/MAP相关性没有显著影响。我们的分析表明,在小儿心脏手术患者中,MAP与rSO2之间的相关性模式因年龄而异。MAP通常与儿童的rSO2呈正相关,但与新生儿或婴儿患者无关。

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