食道氧血球和度作为在出血性休克中复苏的指标
Julia Garcia Mancebo1, Kristen Sack1, Padraic Romfh2
1Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.
Trauma surgery & acute care open
|September 19, 2024
概括
这项研究引入了一种使用共振拉曼光谱的新型非侵入性装置,用于测量组织氧血球蛋白和度 (ShbO2). 食道和舌头的ShbO2准确地反映了混合静脉和度 (SvO2),并预测了休克死亡率.
科学领域:
- 生物医学工程 生物医学工程
- 生理学 生理学 生理学
- 频谱学是一种光谱学.
背景情况:
- 混合静脉和 (SvO2) 是评估在休克时组织氧气输送 (DO2) 充足性的黄金标准.
- 目前的SvO2监测是侵入性的和具有挑战性的.
- 像近红外光谱学这样的非侵入性方法对组织脱氧的敏感性有限.
研究的目的:
- 开发和验证一种使用共振拉曼光谱 (RRS) 进行非侵入性氧血球和 (ShbO2) 测量的新型装置.
- 评估RRS测量的ShbO2与SvO2和血清乳酸在老鼠出血冲击模型中的相关性.
- 评估ShbO2在严重出血性休克中近期死亡率的预测值.
主要方法:
- 制造一个RRS装置来量化食道 (eShbO2),舌头 (tShbO2) 和肝脏 (hShbO2) 中的ShbO2.
- 使用了两种小鼠出血性休克模型.
- 对ShbO2与SvO2和乳酸的相关性分析,并评估ShbO2预测死亡率的能力.
主要成果:
- 食道 (eShbO2) 和舌头 (tShbO2) 的ShbO2与SvO2 (分别r=0.705,p<0.0001和r=0.724,p<0.0001) 和血清乳酸有很强的相关性.
- 肝脏ShbO2 (hShbO2) 与SvO2和乳酸的相关性较差.
- eShbO2和tShbO2在检测严重组织缺氧 (SvO2<20%) 中表现出色,AUC分别为0.843和0.879.
- eShbO2 (40%的门) 和tShbO2 (50%的门) 准确地预测了严重出血性休克的近期死亡率.
- 与侵入性参数相比,ShbO2监测显示出更高的灵敏度,例如平均动脉血压,脉冲压和心率等侵入性参数.
结论:
- 食道ShbO2 (eShbO2) 提供了一种新的非侵入性方法,用于实时评估组织氧气输送 (DO2) 充足度.
- 这种基于RRS的监测方法与SvO2有很好的相关性,并预测死亡时间.
- eShbO2代表了在休克状态下监测组织氧和量的有希望的进步.
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