首页 > 麻醉与镇痛 > 婴儿心脏手术中脑氧饱和度的监测:与手术后早期预后的关系

婴儿心脏手术中脑氧饱和度的监测:与手术后早期预后的关系

Cerebral Oximetry During Infant Cardiac Surgery: Evaluation and Relationship to Early Postoperative Outcome

二维码有效期 120s

摘要背景我们对婴儿心脏手术中脑氧饱和度的变化及其与解剖学诊断和早期预后的关系进行了研究.方法将104例接受双心室修补无主动脉弓缩窄手术的先心病患儿随机分成两组,两组的红细胞比容分别稀释至25%和35%.用近红外光谱仪监测各时点每例患儿的局部脑氧饱和度(rSO2).结果在心肺转流前,与右位型大动脉转位(D-TGA)和室间隔缺损患儿相比,法洛氏四联症(TOF)患儿局部脑氧饱和度较高(P＜0.001).在心肺转流降温、低流量转流及心肺转流结束时,右位型大动脉转位患儿的局部脑氧饱和度最高(P＜0.001).但各组间手术中局部脑氧饱和度和早期预后经校正诊断后并没有明显关系.39例接受≥5分钟深低温停循环[deep hypothermic circulatory arrest(DHCA)]的右位型大动脉转位患儿中,停循环开始时的局部脑氧饱和度(91%±6%)及红细胞比容(29.2%±5.5%)与停循环中的局部脑氧饱和度下降速率没有明显关系.结论手术中局部脑氧饱和度随解剖学诊断不同而变化,但是与手术后早期预后无明显关系.正如使用额叶近红外线光谱探头测量局部脑氧饱和度所示,高红细胞比容与当今的灌注技术似乎可为深低温停循环在短期内提供足够的氧储备.

作者 王珊青 ^[1] Barry D.Kussman ^[2] David Wypij ^[1] James A.DiNardo ^[3] Jane W.Newburger ^[4] John E.Mayer ^[4] Pedro J.del Nido ^[4] Emile A.Bacha ^[4] Frank Pigula ^[5] Ellen McGrath ^[6] Peter C.Laussen 学术成果认领

作者单位 Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston;Department of Anaesthesia, Harvard Medical School ^[1] Department of Cardiology, Children's Hospital Boston;Department of Pediatrics, Harvard Medical School;Department of Biostatis tics, Harvard School of Public Health ^[2] Department of Cardiology, Children's Hospital Boston;Department of Pediatrics, Harvard Medical School;Department of Cardiology, Harvard Medical School ^[3] Department of Cardiovascular Surgery, Children's Hospital Boston;Department of Surgery, Harvard Medical School, Boston, Massachusetts ^[4] Department of Cardiology, Children's Hospital Boston;Department of Cardiology, Harvard Medical School ^[5] Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston;Department of Anaesthesia, Harvard Medical School;Department of Cardiology, Children's Hospital Boston;Department of Cardiology, Harvard Medical School ^[6]

医学主题词氧(Oxygen)预后(Prognosis)脑(Brain)婴儿(Infant)心脏(Heart)

发布时间 2010-12-13（万方平台首次上网日期，不代表论文的发表时间）