【原】【罂粟摘要】麻醉后儿童无创混合静脉血氧饱和度监测新方法的验证

麻醉后儿童无创混合静脉血氧饱和度监测新方法的验证

贵州医科大学        麻醉与心脏电生理课题组

 翻译：周菁    编辑：杨荣峰    审校：曹莹

背景

混合静脉氧饱和度 (SvO₂) 是评估氧供需的关键变量，但由于肺动脉导管的侵入性，很少用于儿童。这项前瞻性观察性研究的目的是研究基于微分 Fick 方程 (Capno-SvO₂ ) 的新型二氧化碳动力学方法与金标准 CO-血氧测定法相比，无创测量 SvO₂ 的准确性。

方法

在接受心脏导管介入治疗和中等血流动力学挑战的儿童中，比较Capno-SvO₂与肺动脉血气共氧仪测量的SvO₂。采用Bland-Altman分析描述CO-血氧测定与Capno-SvO₂绝对值的一致性，并计算一致率来评价Capno-SvO₂跟踪变化的能力。

结果

本研究纳入了25例手术。Capno-SvO₂显示对CO-血氧测定的偏倚为+3个百分点;一致性的上限和下限分别为+11个百分点（95%置信区间[CI]，9-14）和-5个百分点（95% CI，-8至-3）。一致率为92%（95% CI，89-96）。

结论

总之，无需肺动脉导管的无创SvO₂监测新概念的首次临床应用表明，Capno-SvO₂生成的绝对值和趋势能力与金标准参考方法非常一致。

原始文献来源： Svedmyr,A. , Steiner,K. , Andersson,A. , Sjöberg,G. , Hallbäck,M. , Wallin,M. , Lönnqvist,P. ,& Karlsson , J.(2024).Validation of a Novel Method for Noninvasive Mixed Venous Oxygen Saturation Monitoring in Anesthetized Children.Anesthesia & Analgesia,139(4),781-788.

Validation of a Novel Method for Noninvasive Mixed Venous Oxygen Saturation Monitoring in Anesthetized ChildrenAbstract

Background: Mixed venous oxygen saturation (SvO₂) is a critical variable in the assessment of oxygen supply and demand but is rarely used in children due to the invasive nature of pulmonary artery catheters. The aim of this prospective, observational study was to investigate the accuracy of noninvasively measured SvO₂ acquired by the novel capnodynamic method, based on differential Fick equation (Capno-SvO₂), against gold standard CO-oximetry.

METHODS: Capno-SvO₂ was compared to SvO₂ measured by pulmonary artery blood gas CO-oximetry in children undergoing cardiac catheter interventions and subjected to moderate hemodynamic challenges. Bland-Altman analysis was used to describe the agreement of abso-lute values between CO-oximetry and Capno-SvO₂ , and a concordance rate was calculated to evaluate the ability of Capno-SvO₂ to track change.

RESULTS: Twenty-five procedures were included in the study. Capno-SvO₂ showed a bias toward CO-oximetry of +3 percentage points; upper and lower limits of agreement were +11 percentage points (95% confidence interval [CI], 9–14) and −5 percentage points (95% CI, −8 to −3),respectively. The concordance rate was 92% (95% CI, 89–96).

CONCLUSIONS: In conclusion, this first clinical application of a novel concept for noninvasive SvO₂ monitoring without the need for a pulmonary artery catheter indicates that Capno-SvO₂ generates absolute values and trending capacity in close agreement with the gold standard reference method.

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