背景:脊髓缺血是开放和腔内胸腹主动脉修复后可能发生的并发症之一。尽管有各种围手术期方法,包括远端主动脉灌注,带有额外解剖旁路的混合手术,运动诱发电位,脑脊液引流.无法及时识别脊髓缺血仍然是胸腹主动脉修复后的毁灭性并发症。
目的:这篇综述旨在研究设计用于连续监测的新技术,以检测脊髓缺血发展的早期变化,并讨论其益处和局限性。
方法:我们对可用于重症监护病房(ICU)连续监测以早期发现脊髓缺血的技术进行了系统回顾。如果研究在术后期间使用不同的技术监测脊髓缺血,则有资格纳入研究。所有没有英文版本的文章都被排除在外。为了确保包括所有相关条款,没有施加其他重大限制。
结果:从开始到2022年12月,我们确定了59项研究纳入我们的研究。已经研究了新技术作为潜在有用的监测工具,可以提供简单有效的脊髓监测。这些包括近红外光谱,超声造影,磁共振成像,脊髓的光纤监测,和CSF生物标志物。
结论:尽管有新的技术来监测术后脊髓缺血,它们的使用仍然有限。我们建议未来进行更多研究,以确保对我们的患者进行快速干预。
BACKGROUND: Spinal cord ischemia is one of the complications that can occur after open and endovascular thoracoabdominal aortic repair. This occurs despite various perioperative approaches, including distal aortic perfusion, hybrid procedures with extra anatomical bypasses, motor-evoked potential, and cerebrospinal fluid drainage. The inability to recognize spinal ischemia in a timely manner remains a devastating complication after thoracoabdominal aortic repair.This
review aims to look at novel technologies that are designed for continuous monitoring to detect early changes that signal the development of spinal cord ischemia and to discuss their benefits and limitations.
METHODS: We conducted a systematic
review of the technologies available for continuous monitoring in the intensive care unit for early detection of spinal cord ischemia. Studies were eligible for inclusion if they used different technologies for monitoring spinal ischemia during the postoperative period. All articles that were not available in English were excluded. To ensure that all relevant articles were included, no other significant restrictions were imposed.
RESULTS: We identified 59 studies from the outset to December 2022 to be included in our study. New techniques have been studied as potentially useful monitoring tools that could provide simple and effective monitoring of the spinal cord. These include near-infrared spectroscopy, contrast-enhanced ultrasound, magnetic resonance imaging, fiber optic monitoring of the spinal cord, and cerebrospinal fluid biomarkers.
CONCLUSIONS: Despite the development of new techniques to monitor for postoperative spinal cord ischemia, their use remains limited. We recommend more future research to ensure rapid intervention for our patients.