在接受心脏手术的儿科患者中,区域氧和和中心静脉和之间的关联:一项前性观察性研究
Naoki Hirai1, Junichi Saito1, Kishiko Nakai1
1Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Paediatric anaesthesia
|August 3, 2023
概括
在儿科心脏外科手术中,非侵入性脑区域氧和 (rSO2) 与中心静脉氧和 (ScvO2) 相对应. 然而,大脑rSO2的精度不足以取代侵入性ScvO2监测.
科学领域:
- 心脏病学 心脏病学
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
背景情况:
- 监测氧和在儿科心脏手术中至关重要.
- 中枢静脉氧和度 (ScvO2) 是全球氧气平衡的侵入性衡量标准.
- 作为替代方法,正在探索区域氧和 (rSO2) 等非侵入性方法.
研究的目的:
- 评估非侵入性rSO2 (大脑和体质) 与侵入性ScvO2.2之间的相关性.
- 为了确定非侵入性rSO2是否可以在儿科心脏手术患者中作为SkvO2的替代品.
- 评估rSO2在跟踪全球氧气供需平衡中的实用性.
主要方法:
- 一项前性观察性研究,涉及33名儿童 (体重小于10公斤),因先天性心脏病接受心脏手术.
- 在麻醉诱导后同时测量ScvO2,大脑rSO2和体质rSO2.
- 使用皮尔森相关系数,布兰德-阿尔特曼分析和多重回归的统计分析.
主要成果:
- 大脑rSO2与ScvO2显著正相关 (r2=0.29,p=0.002),特别是在没有心房水平混合的患者中 (r2=0.61,p=0.013).
- 实体rSO2与ScvO2.2没有显著的相关性.
- 布兰德-阿尔特曼分析表明,与ScvO2.2相比,大脑和体质rSO2的协议范围很大.
- 手术前的大脑尿性 (BNP) 和SpO2独立地与ScvO2和rSO2.2相关.
结论:
- 大脑rSO2,SpO2和BNP与ScvO2相关,在特定的患者群体中观察到更强的相关性.
- 虽然rSO2,BNP和SpO2可以帮助监测ScvO2趋势,但大脑rSO2缺乏必要的精度来取代侵入性ScvO2监测.
- 对氧和度的非侵入性监测需要进一步研究其在儿科心脏手术中的作用.
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