Suemori Tomohiko, Yamada Takashi, Nagano Tatsuya, Satoh Masaaki, Takeuchi Mamoru
Department of Pediatric Anesthesiology and Intensive Care Medicine, Jichi Children's Medical Center Tochigi, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0498, Japan.
Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
J Anesth. 2025 Jul 11. doi: 10.1007/s00540-025-03545-3.
Time-resolved spectroscopy (TRS) has recently become clinically available and offers superior measurement accuracy over conventional spatially resolved spectroscopy (SRS). This study evaluated the feasibility of transitioning from the SRS-based INVOS 5100C to the TRS-based tNIRS-1 by comparing cerebral oxygen saturation measurements taken during pediatric cardiac surgery.
We retrospectively analyzed data from 149 children (< 6 years) who had undergone cardiac surgery. We compared simultaneously measured cerebral tissue oxygen saturation (StO₂) (tNIRS-1) and regional cerebral oxygen saturation (rSO₂) (INVOS 5100C) after anesthesia induction. Both values were assessed against reference cerebral oxygen saturation (REF CX). Clinical decisions based on StO₂ and rSO₂ were also compared to current reference thresholds.
The Wilcoxon matched-pairs signed-rank test showed significantly lower StO₂ than rSO₂ (54.8 [48.9-61.0] vs. 69 [61-75], p < 0.0001); this observation was consistent across all age groups and cyanotic statuses. Bland-Altman analysis confirmed non-interchangeability (mean bias: - 13.1; limits: - 31.7 to 5.5). Compared with REF CX, rSO₂ more closely reflected true cerebral oxygenation (mean bias: - 5.7; limits: - 22.5 to 11.2) than StO₂ (mean bias: - 19.3; limits: - 36.5 to - 2.1). Most patients were classified as normal by rSO₂ but borderline by StO₂.
A transition from INVOS 5100C to tNIRS-1 is not currently feasible due to clinically significant discrepancies. Therefore, it may be appropriate to either select the device based on the specific measurement objectives or use both devices in a complementary manner.
时间分辨光谱技术（TRS）最近已应用于临床，与传统的空间分辨光谱技术（SRS）相比，其测量精度更高。本研究通过比较小儿心脏手术期间的脑氧饱和度测量值，评估了从基于SRS的INVOS 5100C过渡到基于TRS的tNIRS-1的可行性。
我们回顾性分析了149例（<6岁）接受心脏手术患儿的数据。比较麻醉诱导后同时测量的脑组织氧饱和度（StO₂）（tNIRS-1）和局部脑氧饱和度（rSO₂）（INVOS 5100C）。将这两个值与参考脑氧饱和度（REF CX）进行比较。还将基于StO₂和rSO₂的临床决策与当前参考阈值进行了比较。
Wilcoxon配对符号秩检验显示，StO₂显著低于rSO₂（54.8[48.9-61.0]对69[61-75]，p<0.0001）；这一观察结果在所有年龄组和青紫状态中均一致。Bland-Altman分析证实了两者不可互换（平均偏差：-13.1；范围：-31.7至5.5）。与REF CX相比，rSO₂比StO₂更能准确反映真实的脑氧合情况（平均偏差：-5.7；范围：-22.5至11.2），而StO₂的平均偏差为-19.3；范围：-36.5至-2.1）。大多数患者的rSO₂分类为正常，但StO₂分类为临界。
由于存在临床显著差异，目前从INVOS 5100C过渡到tNIRS-1不可行。因此，根据具体测量目标选择设备或以互补方式使用这两种设备可能是合适的。
