科研之友
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摘要
Rationale and Objectives:. Cerebral oxygen extraction, defined as the difference between arterial and venous oxygen saturations (SaO(2) and SvO(2)), is a critical parameter for managing intensive care patients at risk for neurological collapse. Although quantification of SaO(2) is easily performed with pulse,oximetry or moderately invasive arterial blood: draws in peripheral vessels, cerebral SvO(2) is frequently not Monitored because of the invasiveness and risk associated, with obtaining jugular bulb or Super vena cave.(sve) blood samples. Materials and Methods: In thia study, near-infrared spectroscopy (NIRS) was Used to noninvasively measure, cerebral-SvO(2) in, anesthetized and Mechanically ventilated-pediatric patients (n = 10). To quantify SvO(2), the NIRS signal component that fluctuates at the respiration frequency is isolated. This respiratory component is dominatect by the venous portion of interrogated-vasculature. The NIRS measurements of SvO(2) Were validated against the clinical gold standard: invasively measured oxygen saturations from SVC blood samples. This technique was also applied in healthy volunteers (n = 5) without mechanical ventilation to illustrate-its potential for use in healthy populations with natural airways. Results; Ten pediatric patients with pulmonary hypertension were studied. In these patients, SvO(2) in the SVC exhibited good agreement with NIRS-measured SvO(2),(R-2 = 0.80, F = .001, slope = 1.16 +/- 0.48). Furthermore, in the healthy adult volunteers, mean (standard deviation) NIRS-measured SvO(2) was 79.4 (6.8)%. This value is in good agreement with the expected average central venous Saturation reported in literature. Conclusion: Respiration,frequency-selected NIRS can noninvasively quantify cerebral SvO(2). This bedside technique can be used to help assess brain health in neurologically unstable patients.
- 出版日期2014-2
