Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, USA.
Pendar Technologies, LLC, Cambridge, Massachusetts, USA.
Neonatology. 2023;120(3):363-370. doi: 10.1159/000529624. Epub 2023 Mar 30.
Current oxygen monitoring by pulse oximetry has limitations and cannot provide estimates of the oxygen content in the microvasculature, where oxygen is used. Resonance Raman spectroscopy (RRS) provides noninvasive microvascular oxygen measurement. The objectives of this study were to (i) measure the correlation between preductal RRS microvascular oxygen saturations (RRS-StO2) and central venous oxygen saturation (SCVO2), (ii) develop normative data for RRS-StO2 measurements in healthy preterm infants, and (iii) determine the effect of blood transfusion on RRS-StO2.
Thirty-three buccal and thenar RRS-StO2 measurements were performed in 26 subjects to correlate RRS-StO2 with SCVO2. Thirty-one measurements were performed in 28 subjects to develop normative RRS-StO2 values, and eight subjects were enrolled in the transfusion group to assess changes in RRS-StO2 with blood transfusion.
There were good correlations for buccal (r = 0.692) and thenar (r = 0.768) RRS-StO2 versus SCVO2. The median RRS-StO2 in healthy subjects was 76% (IQR 68.7-80.8). There was a significant increase of 7.8 ± 4.6% in the thenar RRS-StO2 after blood transfusion.
RRS appears to be a safe and noninvasive means of monitoring microvascular oxygenation. Thenar RRS-StO2 measurements are more feasible and practical to use than buccal. In healthy preterm infants, the median RRS-StO2 was calculated based on measurements across various gestational age and gender. More studies evaluating the effects of gestational age of RRS-StO2 in various critical clinical settings are needed to confirm the findings.
目前通过脉搏血氧仪进行的氧气监测存在局限性，无法提供氧气在被利用的微循环中的含量估计。共振拉曼光谱（RRS）提供非侵入性的微血管氧测量。本研究的目的是：（i）测量前置 RRS 微血管氧饱和度（RRS-StO2）与中心静脉氧饱和度（SCVO2）之间的相关性，（ii）制定健康早产儿 RRS-StO2 测量的正常参考值，以及（iii）确定输血对 RRS-StO2 的影响。
在 26 名受试者中进行了 33 次颊部和鱼际 RRS-StO2 测量，以将 RRS-StO2 与 SCVO2 相关联。在 28 名受试者中进行了 31 次测量，以制定正常 RRS-StO2 值，并且在输血组中招募了 8 名受试者以评估输血对 RRS-StO2 的影响。
颊部（r = 0.692）和鱼际（r = 0.768）RRS-StO2 与 SCVO2 之间存在良好的相关性。健康受试者的 RRS-StO2 中位数为 76%（IQR 68.7-80.8）。输血后鱼际 RRS-StO2 增加了 7.8 ± 4.6%。
RRS 似乎是一种安全且非侵入性的监测微血管氧合的方法。与颊部相比，鱼际 RRS-StO2 测量更可行且实用。在健康的早产儿中，基于各种胎龄和性别进行的测量，计算出了 RRS-StO2 的中位数。需要更多的研究来评估 RRS-StO2 在各种关键临床环境中的胎龄效应，以确认这些发现。
