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Monitoring of Cerebral Oxygenation by Near-infrared Spectroscopy during Cardiopulmonary Bypass in Infants

工程科学（英文版） 2006年第3期4卷 11-16,28页

作者： Su Zhaokang Huang Jihong Wang Shunmin Department of Pediatric Thoracic and Cardiovascular Surgery Shanghai Children＇s Medical Center Shanghai Jiaotong University Medical College Shanghai 200127

Objective: To evaluate the use of near-infrared spectroscopy for monitoring cerebral oxygenation under different cardiopulmonary bypass models. Method: Twenty-four patients with ventricular septal defect and pulmonary hypertension undergoing open-heart surgery were assigned eight each to three groups, with respect to different cardiopulmonary bypass models: moderate hypothermia cardiopulmonary bypass, deep hypothermia low flow and deep hypothermia circulatory arrest. For each patient, cerebral oxygenation with near-infrared spectroscopy were monitored and the relative concentration changes in cerebral oxygenated hemoglobin, deoxygenated hemoglobin and oxidized cytochrome aa3 were calculated. Electroencephalography, biochemical indicators such as neuron-specific enolase and lactate, and performed correlation analyses for near-infrared spectroscopy data and biochemical indicators were also measured. Results: Near-infrared spectroscopy data and biochemical indicators for moderate hypothermia cardiopulmonary bypass and deep hypothermia low flow group showed no correlation. For deep hypothermia circulatory arrest group, oxygenated hemoglobin signal declined to a plateau （nadir） during the circulatory arrest period. The duration from reaching nadir until reperfusion “oxygenated hemoglobin signal nadir-time", and the minimum values of oxygenated hemoglobin, and oxidized cytochrome aa3 were closely correlated with increasing neuron-specific enolase and lactate. And, all patients whose oxygenated hemoglobin signal nadir-time was less than 35 min were free from behavioral evidence of brain injury. Conclusion: Near-infrared spectroscopy data including oxygenated hemoglobin signal nadir-time and the minimum of oxygenated hemoglobin and oxidized cytochrome aa3 showed strong correlation with other cerebral function assessment for deep hypothermia circulatory arrest. Oxygenated hemoglobin signal nadir-time determined by near-infrared spectroscopy can be useful in predicting the sa

关键词：新生儿近红外分光学低温心肺分流术深低温低流动性深低温循环骤停氧络血红蛋白

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