脑氧监测仪.ppt

INVOS 脑氧饱和度仪NEUROLOGICAL INJURY INVOS 的意思是 In-Vivo Optical Spectroscopy INVOS? 利用近红外光测量脑组织的氧供给和氧需求的平衡状态。 这台仪器是如何工作的? INVOS 脑氧饱和度仪可以发射出无损伤性的低密度近红外光线，通过病人前额的贴片进入颅骨和大脑皮层。通过测量两个相距一定距离的光源（3 厘米和4 厘米）所发射光线的反射光，从而测量得到脑组织中血液吸收的光量。 INVOS 脑氧饱和度仪使用两种波长的光(730 and 805 nm)，使用两个LEDs (lightemittingdiodes) 光源，交替发射光波。 Thanks Because the measurement is predominantly venous, the Cerebral Oximeter responds to changes in both oxygen delivery and oxygen consumption. 42 volunteers underwent an IRB-approved study where cerebral oximetry was compared to blood samples during ten levels of SaO2 and etCO2. The first run, at resting CO2 +2 mmHg, included SaO2 levels of 75%, 80%, 90%, 96% and 100%. The second run repeated the five SaO2 levels at hypercapnia, +5 mmHg above the first run. An end-tidal forcing system kept gas levels within 2% breath-to-breath. Oximetry data was compared to arterial and jugular venous saturation combined in a 1:3 ratio (field saturation). In the same study, changes in the field saturation (0.25 x arterial saturation plus 0.75 x jugular venous saturation) were compared to changes in cerebral oximetry. Both individual and pooled correlations were very high, 0.95. Changes in rSO2 were not significant during selective clamping of the external carotid (EC) artery (scalp blood supply) but were significant following clamping of the internal carotid (IC) artery (brain blood supply). Changes of rSO2 on the contralateral side were minimal during clamping. This observational study compared drops in rSO2 with obvious neurological changes in awake patients. The four patients with obvious neurologic symptoms had relative rSO2 declines greater than –27%. The remaining patients had less than –23% rSO2 declines and demonstrated no changes in neurologic status. This observational study compared changes in rSO2 with changes in processed EEG which was used to determine the need to shunt. The authors calculated the sensitivity and specificity of various threshold reductio