Yoxall C W, Weindling A M, Dawani N H, Peart I
Department of Child Health, University of Liverpool, Liverpool Maternity Hospital, United Kingdom.
Pediatr Res. 1995 Sep;38(3):319-23. doi: 10.1203/00006450-199509000-00008.
Changes in cerebral venous oxyhemoglobin saturation reflect changes in the balance between cerebral oxygen delivery and cerebral oxygen consumption. Invasive monitoring of cerebral venous saturation (CSVO2) has provided useful information in the management of critically ill adults at risk of cerebral hypoxia. This study describes the development and validation of a non-invasive method of measuring CSVO2 suitable for use in sick neonates using near-infrared spectroscopy (NIRS) and partial jugular venous occlusion. This technique was validated by comparison with an invasive measurement of CSVO2, co-oximetry of jugular bulb blood obtained during cardiac catheterization. Agreement between the two methods was assessed using the method of J. M. Bland and D. G. Altman. Fifteen children were studied, aged 3 mo to 14 y (median 2 y). CSVO2 by co-oximetry ranged from 36 to 80% (median 60%). The mean difference (Co-Oximeter - NIRS) was 1.5%. Limits of agreement were -12.8 to 15.9%. Three different methods of analyzing the NIRS signal were compared. The best agreement was obtained when the changes occurring during the first 5 s of partial jugular venous occlusion were studied. Greatest accuracy was seen in those subjects with least movement artifact, and we believe this technique will be reliable in sick neonates.
脑静脉氧合血红蛋白饱和度的变化反映了脑氧输送与脑氧消耗之间平衡的变化。对脑静脉饱和度（CSVO2）进行有创监测，在管理有脑缺氧风险的危重症成人方面提供了有用信息。本研究描述了一种适用于患病新生儿的非侵入性测量CSVO2方法的开发与验证，该方法使用近红外光谱（NIRS）和部分颈静脉闭塞。通过与CSVO2的有创测量（即心脏导管插入术期间获得的颈静脉球血氧定量法）进行比较，对该技术进行了验证。使用J.M.布兰德和D.G.奥尔特曼的方法评估两种方法之间的一致性。对15名年龄在3个月至14岁（中位数2岁）的儿童进行了研究。通过血氧定量法测得的CSVO2范围为36%至80%（中位数60%）。平均差异（血氧定量法 - NIRS）为1.5%。一致性界限为 -12.8%至15.9%。比较了三种不同的分析NIRS信号的方法。研究部分颈静脉闭塞最初5秒内发生的变化时，一致性最佳。在运动伪影最少的受试者中观察到最高的准确性，我们认为该技术在患病新生儿中是可靠的。
