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体外循环期间连续颈静脉球部血氧饱和度测定的准确性

Accuracy of continuous jugular bulb venous oximetry during cardiopulmonary bypass.

作者信息

Nakajima T, Ohsumi H, Kuro M

机构信息

Department of Anesthesiology, National Cardiovascular Center, Osaka, Japan.

出版信息

Anesth Analg. 1993 Dec;77(6):1111-5. doi: 10.1213/00000539-199312000-00005.

DOI:10.1213/00000539-199312000-00005
PMID:8250299
Abstract

We evaluated the accuracy of fiberoptic catheter oximetry in the jugular bulb during conditions of normothermia, hemodilution, and hypothermia in 11 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB). An oximetry catheter was inserted into the right jugular bulb under general anesthesia, calibrated by the in vitro (n = 7) or in vivo (n = 4) mode. Jugular bulb oxygen saturation (SjO2) with the catheter oximeter was compared with a concurrent laboratory CO-oximeter value from a blood sample during surgery. Nasopharyngeal temperature (NPT) and hemoglobin concentration (Hb) were also measured. The oximetric catheter SjO2 correlated closely with the CO-oximeter determinations in both calibration modes (in vitro, r2 = 0.88; in vivo; r2 = 0.96). Data in the in vitro calibrated group were grouped into three conditions; 1) normothermia and no hemodilution, 2) normothermia and hemodilution, and 3) hypothermia and hemodilution, and showed good correlations between SjO2 values measured by the two methods (r2 = 0.90, r2 = 0.81, r2 = 0.79, respectively). The difference in SjO2 values by the two methods was not significantly affected by changes in NPT and Hb during CPB. In conclusion, the continuous SjO2 monitoring with catheter oximetry during CPB would be accurate and reliable under either calibration mode. Moderate hypothermia and hemodilution during CPB did not significantly influence the accuracy.

摘要

我们评估了11例接受体外循环心脏手术(CPB)患者在正常体温、血液稀释和低温条件下,颈静脉球部光纤导管血氧饱和度测定法的准确性。在全身麻醉下将血氧饱和度测定导管插入右颈静脉球部,通过体外(n = 7)或体内(n = 4)模式进行校准。将导管血氧饱和度测定仪测得的颈静脉球部血氧饱和度(SjO2)与手术期间同时采集的血样经实验室一氧化碳血氧饱和度测定仪测得的值进行比较。还测量了鼻咽温度(NPT)和血红蛋白浓度(Hb)。在两种校准模式下,血氧测定导管的SjO2与一氧化碳血氧饱和度测定仪的测定结果密切相关(体外,r2 = 0.88;体内,r2 = 0.96)。体外校准组的数据分为三种情况:1)正常体温且无血液稀释,2)正常体温且血液稀释,3)低温且血液稀释,两种方法测得的SjO2值之间均显示出良好的相关性(分别为r2 = 0.90、r2 = 0.81、r2 = 0.79)。CPB期间,两种方法测得的SjO2值差异不受NPT和Hb变化的显著影响。总之,CPB期间采用导管血氧饱和度测定法连续监测SjO2在任何一种校准模式下都是准确可靠的。CPB期间的中度低温和血液稀释对准确性没有显著影响。

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