PDF(Pubmed)
Abstract：
UNASSIGNED: Near-infrared spectroscopy (NIRS) is a commonly used technique to evaluate tissue oxygenation and prevent harmful cerebral desaturation in the perioperative setting. The aims of the present study were to assess whether surgery-related anemia can be detected via NIRS of cerebral oxygen saturation and to investigate the effects of different perioperative transfusion strategies on cerebral oxygenation, potentially affecting transfusion decision-making.
UNASSIGNED: Data from the ongoing multicenter LIBERAL-Trial (liberal transfusion strategy to prevent mortality and anemia-associated ischemic events in elderly noncardiac surgical patients, LIBERAL) were used. In this single-center sub-study, regional cerebral oxygenation saturation (rSO2) was evaluated by NIRS at baseline, pre-, and post-RBC transfusion. The obtained values were correlated with blood gas analysis-measured Hb concentrations.
UNASSIGNED: rSO2 correlated with Hb decline during surgery (r = 0.35, p < 0.0001). Different RBC transfusion strategies impacted rSO2 such that higher Hb values resulted in higher rSO2. Cerebral desaturation occurred at lower Hb values more often.
UNASSIGNED: Cerebral oxygenation monitoring using NIRS provides noninvasive rapid and continuous information regarding perioperative alterations in Hb concentration without the utilization of patients\' blood for blood sampling. Further investigations are required to demonstrate if cerebral rSO2 may be included in future individualized transfusion decision strategies.
UNASSIGNED: Data from the ongoing multicenter LIBERAL-Trial (liberal transfusion strategy to prevent mortality and anemia-associated ischemic events in elderly noncardiac surgical patients, LIBERAL) were used. In this single-center sub-study, regional cerebral oxygenation saturation (rSO2) was evaluated by NIRS at baseline, pre-, and post-RBC transfusion. The obtained values were correlated with blood gas analysis-measured Hb concentrations.
UNASSIGNED: rSO2 correlated with Hb decline during surgery (r = 0.35, p < 0.0001). Different RBC transfusion strategies impacted rSO2 such that higher Hb values resulted in higher rSO2. Cerebral desaturation occurred at lower Hb values more often.
UNASSIGNED: Cerebral oxygenation monitoring using NIRS provides noninvasive rapid and continuous information regarding perioperative alterations in Hb concentration without the utilization of patients\' blood for blood sampling. Further investigations are required to demonstrate if cerebral rSO2 may be included in future individualized transfusion decision strategies.
摘要：
■近红外光谱（NIRS）是一种常用的技术，用于评估围手术期的组织氧合并预防有害的大脑去饱和。本研究的目的是评估是否可以通过NIRS的脑氧饱和度检测到手术相关的贫血，并探讨不同的围手术期输血策略对脑氧合的影响。可能影响输血决策。
■来自正在进行的多中心IBERAL试验的数据（在老年非心脏手术患者中预防死亡率和贫血相关缺血事件的自由输血策略，使用了LIBERAL）。在这个单中心的子研究中，基线时通过NIRS评估局部脑氧合饱和度（rSO2），pre,和红细胞输注后。获得的值与血气分析测得的Hb浓度相关。
■rSO2与手术过程中Hb下降相关（r=0.35，p<0.0001）。不同的RBC输注策略影响rSO2,使得较高的Hb值导致较高的rSO2。较低的Hb值下发生脑去饱和的频率更高。
■使用NIRS进行脑氧合监测可提供有关围手术期Hb浓度变化的无创快速连续信息，而无需使用患者血液进行血液采样。需要进一步的调查以证明大脑rSO2是否可以包括在未来的个性化输血决策策略中。
■来自正在进行的多中心IBERAL试验的数据（在老年非心脏手术患者中预防死亡率和贫血相关缺血事件的自由输血策略，使用了LIBERAL）。在这个单中心的子研究中，基线时通过NIRS评估局部脑氧合饱和度（rSO2），pre,和红细胞输注后。获得的值与血气分析测得的Hb浓度相关。
■rSO2与手术过程中Hb下降相关（r=0.35，p<0.0001）。不同的RBC输注策略影响rSO2,使得较高的Hb值导致较高的rSO2。较低的Hb值下发生脑去饱和的频率更高。
■使用NIRS进行脑氧合监测可提供有关围手术期Hb浓度变化的无创快速连续信息，而无需使用患者血液进行血液采样。需要进一步的调查以证明大脑rSO2是否可以包括在未来的个性化输血决策策略中。
