UNASSIGNED:近红外光谱(NIRS)是一种非侵入性方法,可测量脑区氧饱和度(rScO2)。在这项研究中,我们通过探讨先天性心脏病(CHD)患儿围手术期NIRSrScO2与颈静脉球部静脉血氧饱和度(SjvO2)及中心静脉血氧饱和度(ScvO2)的相关性和一致性,比较两者的均值和标准差,评估了NIRS的有效性以及NIRS与常见侵入性方法的互换性的证据.
UNASSIGNED:我们搜索了电子书目数据库(PubMed,Cochrane图书馆和Embase)并筛选符合纳入标准的研究。我们纳入了围手术期接受NIRSrScO2和SjvO2或NIRSrScO2和ScvO2检测的CHD儿科患者的横断面研究。进行方法学质量评价和异质性分析。我们定性地总结了Bland-Altman分析的结果。元回归,亚组分析,并进行了敏感性分析,以探讨异质性的原因。
UNASSIGNED:rScO2和ScvO2之间或rScO2和SjvO2之间的Cohend没有显着差异(Cohend=0.06,95%CI:-0.16至0.28;Cohend=0.03,95%CI:分别为-0.25至0.31),并且存在显着差异(I2=7%,异质性6.0P<0.001;I2=73.6%,分别为P<0.001)。rScO2与ScvO2之间或rScO2与SjvO2之间存在正线性相关(r=0.58,95%CI:0.54至0.63;r=0.60,95%CI:0.54至0.66),异质性不显著(I2=36.7%,P=0.065;I2=12.7%,分别为P=0.328)。在大多数研究中,Bland-Altman分析的95%协议限制很大。没有观察到发表偏倚的证据。
UNASSIGNED:NIRS测得的rScO2在一定程度上反映了冠心病患儿围手术期通过侵入性测量监测的SjvO2和ScvO2。然而,rScO2和SjvO2以及ScvO2之间的协议的广泛限制表明,NIRS和SjvO2以及ScvO2是不可互换的。NIRS在监测CHD患儿脑氧饱和度方面是否发挥重要作用尚需进一步研究。
UNASSIGNED: Near-infrared spectroscopy (NIRS) is a non-invasive approach that measures cerebral regional oxygen saturation (rScO2). In this study, we evaluated the evidence on the validity of NIRS and the interchangeability between NIRS and common invasive approaches by exploring the correlation and consistency and comparing the mean and standard deviation between the NIRS rScO2 and jugular bulb venous oxygen saturation (SjvO2) as well as central venous oxygen saturation (ScvO2) in the perioperative period of children with congenital heart disease (CHD).
UNASSIGNED: We searched electronic bibliographic databases (PubMed, The Cochrane Library and Embase) and screened the studies that met the inclusion criteria. We included cross-sectional studies of CHD pediatric patients in the perioperative period receiving both tests for NIRS rScO2 and SjvO2 or NIRS rScO2 and ScvO2. Methodological quality assessment and heterogeneity analyses were performed. We qualitatively summarized the results of Bland-Altman\'s analysis. Meta-regression, subgroup analyses, and sensitivity analyses were carried out to explore the causes of heterogeneity.
UNASSIGNED: There was no significant difference in Cohen\'s d between rScO2 and ScvO2 or between rScO2 and SjvO2 (Cohen\'s d =0.06, 95% CI: -0.16 to 0.28; Cohen\'s d =0.03, 95% CI: -0.25 to 0.31, respectively) and notable heterogeneity existed (I2=76.0%, P<0.001; I2=73.6%, P<0.001, respectively). A positive linear correlation was present between rScO2 and ScvO2 or between rScO2 and SjvO2 (r=0.58, 95% CI: 0.54 to 0.63; r=0.60, 95% CI: 0.54 to 0.66, respectively) and the heterogeneity was not significant (I2=36.7%, P=0.065; I2=12.7%, P=0.328, respectively). In most studies, the 95% limits of agreements of Bland-Altman\'s analysis were large. No evidence of publication bias was observed.
UNASSIGNED: The rScO2 measured by NIRS reflected the SjvO2 and ScvO2 monitored by invasive measurements in the perioperative period of children with CHD to some extent. However, wide limits of agreements between rScO2 and SjvO2 as well as ScvO2 indicated that NIRS and SjvO2 as well as ScvO2 are not interchangeable. Whether NIRS plays a prominent role in monitoring cerebral oxygen saturation in children with CHD needs further research.