摘要
目的通过健康志愿者降氧试验对比INVOS 5100C(美敦力),EGOS-600(爱琴)和BRS-1(中科搏锐)脑氧测量值的变化情况,仪器的一致性、相关性以及检测关键去饱和事件的能力。方法2021年12月6日至2022年1月18日,招募陆军军医大学第二附属医院健康志愿者20名。采用随机数字表法将受试者分为两组,其中E组使用INVOS 5100C和EGOS-600的单个传感器,B组使用INVOS 5100C和BRS-1的传感器,每组10人。将各自的单个传感器贴于受试者前额后,通过调节吸入氮气和氧气的比例来诱导和逆转缺氧,并连续记录局部脑组织氧饱和度(regional cerebral oxygen saturation,rSO_(2)),受试者的心率(heart rate,HR)、脉搏氧饱和度(pulse oxygen saturation,SPO_(2))随时间的变化情况。统计方法使用Wilcoxon检验评估各设备之间rSO_(2)基线值及变化情况。Bland-Altman和Deming回归分析两组仪器的一致性及相关性。受试者工作特征曲线(receiver operator characteristic curve,ROC)分析不同仪器检测低氧的效能。结果所有设备都对吸入氧浓度的变化做出了相似的反应。①EGOS-600和BRS-1的rSO_(2)变化幅度及速率均小于INVOS 5100C,INVOS 5100C、EGOS-600和BRS-1的ΔrSO_(2)分别为(16%~34.15%)、(6%~20.81%)和(5%~23.81%),绝对中位数变化率分别为(2.81~4.40%/min)、(1.50~2.14%/min)及(1.77~2.41%/min)。②Bland-Altman分析显示EGOS-600和BRS-1与INVOS 5100C的差异均值分别为5.7、2.5;Deming回归显示Person系数分别为0.7224、0.8459,P<0.001,与INVOS 5100C的一致性及相关性均较好。③以INVOS 5100C相对降低10%、20%和50%的绝对值作为关键的干预性rSO_(2)阈值方面,EGOS-600检出率为90%、48%和40%,BRS-1检出率为80%、48%和50%。④ROC结果显示EGOS-600和BRS-1的AUC值分别为0.893、0.715,缺氧预测阈值(cut-off)分别为59.3%、56%。结论EGOS-600和BRS-1对氧合变化的反应与INVOS 5100C相似,相关性及一致性较好,可以准确地预测脑氧变化。
ObjectiveBy comparing the differences in cerebral oxygen parameters with 3 brands of near-infrared spectrometers,INVOS 5100C(Medtronic),EGOS-600(Aegean)and BRS-1(Casibrain Technology),to investigate their consistency,correlation and ability to detect key desaturation events in healthy volunteers in a hypoxic condition.MethodsFrom December 6,2021 to January 18,2022,20 healthy volunteers were recruited from our hospital.They were randomly divided into group E(a single sensor of INVOS 5100C at the left forehead and that of EGOS-600 at the right)and group B(INVOS 5100C and BRS-1,as the other group),with 10 subjects in each group.After the sensors were applied to the forehead of the subject,hypoxia was induced and reversed by adjusting the ratio of inhaled nitrogen to oxygen.Regional cerebral oxygen saturation(rSO_(2)),heart rate and pulse oxygen saturation(SPO_(2))were continuously monitored and recorded in the whole process.Wilcoxon test was used to assess the baseline value and changes in rSO_(2) between different devices.Bland-Altman and Deming regression analyses were employed to analyze the consistency and correlation between the 2 devices.Receiver operating characteristic(ROC)curve was plotted to analyze the performance of the different devices in detection of hypoxia.ResultsAll 3 devices responded similarly to the changes in inhaled oxygen concentration.①The magnitude and rate of changes in rSO_(2) for EGOS-600 and BRS-1 were less than those of INVOS 5100C.The ΔrSO_(2) for INVOS 5100C,EGOS-600 and BRS-1 was 16%~34.15%,6%~20.81%and 5%~23.81%,with an absolute median rate of change of(2.81~4.40)%/min,(1.50~2.14)%/min and(1.77~2.41)%/min,respectively.②Bland-Altman analysis showed that the mean difference of EGOS-600 and BRS-1 to INVOS 5100C were 5.7 and 2.5 respectively.Deming regression displayed that the Person coefficient was 0.7224 and 0.8459,respectively(P<0.001),which were in good consistency and correlation with INVOS 5100C.③In terms of absolute values of 10%,20% and 50% relative reduction in INVOS 5
作者
李阳
彭滔滔
左都坤
李洪
LI Yang;PENG Taotao;ZUO Dukun;LI Hong(Department of Anesthesiology,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400037,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2023年第8期772-779,共8页
Journal of Army Medical University
基金
国家重点研发计划(2018YFC0117200)。
关键词
近红外光谱
脑氧饱和度
缺氧
near infrared spectroscopy
cerebral oxygen saturation
hypoxia
