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小儿主动脉缩窄手术中近红外光谱(NIRS)与有创动脉压监测的相关性

Correlation of Near-Infrared Spectroscopy (NIRS) with Invasive Arterial Pressure Monitoring during Aortic Coarctation Surgery in Pediatric Patients.

作者信息

Pjevalica Dragic Jelena, Zecevic Tatjana, Divac Ivan, Pavlovic Andrija, Bisenic Dejan, Stanisic Luka, Kalanj Jasna, Stefanovic Igor, Nikolic Dejan, Petrov Ivana, Milovanovic Vladimir

机构信息

Department of Cardiac Surgery, University Children's Hospital, 11000 Belgrade, Serbia.

Department of Cardiology, University Children's Hospital, 11000 Belgrade, Serbia.

出版信息

Healthcare (Basel). 2024 Sep 20;12(18):1884. doi: 10.3390/healthcare12181884.

Abstract

Aortic coarctation surgery in pediatric patients requires the placement of two arterial cannulas to monitor pressure gradients and surgical correction adequacy. Near-infrared spectroscopy (NIRS) monitoring provides insight into regional blood flow. This study aimed to investigate the correlation between NIRS values and invasive arterial pressures, exploring NIRS monitoring as a potential substitute for arterial cannulation. In a cohort of 21 consecutive pediatric patients undergoing aortic coarctation surgery, recordings of NIRS and invasive arterial pressure values were evaluated at various time intervals. Pearson correlation evaluated the relationship between NIRS values and invasively measured arterial pressures. Moderate to strong correlations were observed between the mean arterial pressure (MAP) of the upper and lower arteries and cerebral (rSO-C) and somatic (rSO-S) NIRS values 5 min after cross-clamp placement (r = 0.621, = 0.003; r = 0.757, < 0.001). Strong correlations were found 15 min after cross-clamp placement (r = 0.828, = 0.002; r = 0.783, = 0.004). Before transfer to the ICU, a strong correlation existed between the upper artery MAP and rSO-C (r = 0.730, < 0.001), but there was no correlation between the lower artery MAP and rSO-S. These findings are promising, but further studies are required to validate it as a reliable substitute for invasive pressure monitoring in this patient population.

摘要

小儿患者的主动脉缩窄手术需要放置两根动脉插管,以监测压力梯度和手术矫正的充分性。近红外光谱(NIRS)监测可深入了解局部血流情况。本研究旨在调查NIRS值与有创动脉压之间的相关性,探索将NIRS监测作为动脉插管的潜在替代方法。在一组连续21例接受主动脉缩窄手术的小儿患者中,在不同时间间隔评估NIRS和有创动脉压值的记录。Pearson相关性分析评估NIRS值与有创测量的动脉压之间的关系。在阻断钳放置后5分钟,上、下肢动脉的平均动脉压(MAP)与脑(rSO-C)和躯体(rSO-S)NIRS值之间观察到中度至强相关性(r = 0.621,P = 0.003;r = 0.757,P < 0.001)。在阻断钳放置后15分钟发现强相关性(r = 0.828,P = 0.002;r = 0.783,P = 0.004)。在转至重症监护病房(ICU)之前,上肢动脉MAP与rSO-C之间存在强相关性(r = 0.730,P < 0.001),但下肢动脉MAP与rSO-S之间无相关性。这些发现很有前景,但需要进一步研究以验证其作为该患者群体有创压力监测的可靠替代方法。

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