Gomez Alwyn, Griesdale Donald, Froese Logan, Yang Eleen, Thelin Eric P, Raj Rahul, Aries Marcel, Gallagher Clare, Bernard Francis, Kramer Andreas H, Zeiler Frederick A
Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
Bioengineering (Basel). 2023 Sep 25;10(10):1124. doi: 10.3390/bioengineering10101124.
Brain tissue oxygen tension (PbtO) has emerged as a cerebral monitoring modality following traumatic brain injury (TBI). Near-infrared spectroscopy (NIRS)-based regional cerebral oxygen saturation (rSO) can non-invasively examine cerebral oxygen content and has the potential for high spatial resolution. Past studies examining the relationship between PbtO and NIRS-based parameters have had conflicting results with varying degrees of correlation. Understanding this relationship will help guide multimodal monitoring practices and impact patient care. The aim of this study is to examine the relationship between PbtO and rSO in a cohort of TBI patients by leveraging contemporary statistical methods. A multi-institutional retrospective cohort study of prospectively collected data was performed. Moderate-to-severe adult TBI patients were included with concurrent rSO and PbtO monitoring during their stay in the intensive care unit (ICU). The high-resolution data were analyzed utilizing time series techniques to examine signal stationarity as well as the cross-correlation relationship between the change in PbtO and the change in rSO signals. Finally, modeling of the change in PbtO by the change in rSO was attempted utilizing linear methods that account for the autocorrelative nature of the data signals. A total of 20 subjects were included in the study. Cross-correlative analysis found that changes in PbtO were most significantly correlated with changes in rSO one minute earlier. Through mixed-effects and time series modeling of parameters, changes in rSO were found to often have a statistically significant linear relationship with changes in PbtO that occurred a minute later. However, changes in rSO were inadequate to predict changes in PbtO. In this study, changes in PbtO were found to correlate most with changes in rSO approximately one minute earlier. While changes in rSO were found to contain information about future changes in PbtO, they were not found to adequately model them. This strengthens the body of literature indicating that NIRS-based rSO is not an adequate substitute for PbtO in the management of TBI.
脑组织氧分压（PbtO）已成为创伤性脑损伤（TBI）后一种脑监测方式。基于近红外光谱（NIRS）的局部脑氧饱和度（rSO）能够无创检测脑氧含量，且具有高空间分辨率的潜力。以往研究脑氧分压与基于近红外光谱参数之间的关系时，结果相互矛盾，相关性程度各异。了解这种关系将有助于指导多模式监测实践并影响患者护理。本研究的目的是通过运用当代统计方法，在一组TBI患者中研究PbtO与rSO之间的关系。对前瞻性收集的数据进行了多机构回顾性队列研究。纳入中重度成年TBI患者，他们在重症监护病房（ICU）住院期间同时进行rSO和PbtO监测。利用时间序列技术分析高分辨率数据，以检查信号平稳性以及PbtO变化与rSO信号变化之间的互相关关系。最后，尝试使用考虑数据信号自相关性质的线性方法，通过rSO变化对PbtO变化进行建模。该研究共纳入20名受试者。互相关分析发现，PbtO变化与一分钟前的rSO变化相关性最为显著。通过对参数进行混合效应和时间序列建模，发现rSO变化通常与一分钟后发生的PbtO变化存在具有统计学意义的线性关系。然而，rSO变化不足以预测PbtO变化。在本研究中，发现PbtO变化与大约一分钟前的rSO变化相关性最大。虽然发现rSO变化包含有关PbtO未来变化的信息，但未发现它们能充分对其进行建模。这进一步证明了相关文献观点，即基于近红外光谱的rSO在TBI管理中不能充分替代PbtO。
