球囊房间隔造口术对大动脉转位新生儿脑氧合的影响。
Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries.
机构信息
Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
出版信息
Pediatr Res. 2013 Jan;73(1):62-7. doi: 10.1038/pr.2012.147. Epub 2012 Oct 24.
BACKGROUND
The aim of this study was to determine the effect of balloon atrial septostomy (BAS) on cerebral oxygenation in neonates with transposition of the great arteries (TGA).
METHODS
In term neonates with TGA, regional cerebral tissue oxygen saturation (r(c)SO(2)) was measured using near-infrared spectroscopy (NIRS) for a period of 2 h, before BAS, after BAS, and 24 h after BAS. In neonates who did not require BAS on clinical grounds, r(c)SO(2) was measured within 24 h of admission and 24 h later.
RESULTS
BAS was performed in 12 of 21 neonates. r(c)SO(2) increased from a median of 42% (before) to 48% at 2 h after BAS (P < 0.05), as did transcutaneous arterial oxygen saturation (spO(2)) (from 72% to 85%, P < 0.01). r(c)SO(2) increased further during the next 24 h (from 48% to 64%, P < 0.05), whereas spO(2) remained stable. Although beginning from a lower baseline (42 vs. 51%, P < 0.01), r(c)SO(2) was higher in neonates treated with BAS, as compared with neonates not treated with BAS, 24 h after the procedure (64 vs. 58%, P < 0.05); spO(2) was, however, similar between the two groups.
CONCLUSION
BAS improves cerebral oxygen saturation in neonates with TGA. Complete recovery of cerebral oxygen saturation occurred only 24 h after BAS.
背景
本研究旨在探讨球囊房间隔造口术（BAS）对大动脉转位（TGA）新生儿脑氧合的影响。
方法
在 TGA 的足月新生儿中，使用近红外光谱（NIRS）在 BAS 前、BAS 后和 BAS 后 24 小时测量局部脑组织氧饱和度（r(c)SO(2)）。对于因临床原因不需要 BAS 的新生儿，在入院后 24 小时内和 24 小时后测量 r(c)SO(2)。
结果
21 例新生儿中有 12 例行 BAS。r(c)SO(2)从基线中位数 42%（术前）增加到 BAS 后 2 小时的 48%（P < 0.05），经皮动脉血氧饱和度（spO(2)）也从 72%增加到 85%（P < 0.01）。r(c)SO(2)在接下来的 24 小时内进一步增加（从 48%增加到 64%，P < 0.05），而 spO(2)保持稳定。尽管基线较低（42 比 51%，P < 0.01），但与未接受 BAS 治疗的新生儿相比，接受 BAS 治疗的新生儿在手术后 24 小时时 r(c)SO(2)更高（64 比 58%，P < 0.05）；然而，两组之间的 spO(2)相似。
结论
BAS 可改善 TGA 新生儿的脑氧饱和度。BAS 后仅 24 小时脑氧饱和度完全恢复。
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