In the preoperative management of congenital heart disease (CHD) with increased pulmonary blood flow, hypoxic gas management to control pulmonary blood flow is useful. However, the cerebral oxygenation state has rarel...In the preoperative management of congenital heart disease (CHD) with increased pulmonary blood flow, hypoxic gas management to control pulmonary blood flow is useful. However, the cerebral oxygenation state has rarely been studied, and there is concern about neurologic development. In eight infants with CHD accompanied by increased pulmonary blood flow,hypoxia was induced after a 1-h baseline period in room air (FiO2, 0.21). The infants were simultaneously monitored in both the fronttemporal region and the right-brachial region for 90 min using near-infrared spectroscopy (NIRS). The minimum SaO2 (pulse oximetry) after hypoxic gas administration was 80.8 ± 2.9% when the minimum FiO2 was 16.2 ± 1.1% . With a decrease in SaO2, oxy-Hb (O2Hb) decreased and total Hb cHb: O2Hb + deoxy-Hb (HHb) increased in both regions in the majority of infants. HHb increased in both regions with a decrease in SaO2. The maximum change in the tissue oxygenation index (TOI:O2Hb/cHb × 100) was -8.3 ± 2.6% in the front-temporal region and -3.6 ± 2.3% in the right-brachial region. Cerebral oxygenation decreased despite an increase in cerebral blood flow during hypoxic gas management. The change in TOI was ≤ 10% when the SaO2 was ≥ 80% . Safer control of SaO2 should be maintained over 80% for hypoxia management in CHD based on the results of the present study.展开更多
食管胃静脉曲张出血（esophageal and gastric variceal eeding．EGVB）是门脉高压症最常见、病死率最高的并发症之一，是因为门静脉系统血流受阻和（或）血流量增加，门静脉及其属支血管内静脉压升高．其中门静脉系统的胃冠状静脉与腔...食管胃静脉曲张出血（esophageal and gastric variceal eeding．EGVB）是门脉高压症最常见、病死率最高的并发症之一，是因为门静脉系统血流受阻和（或）血流量增加，门静脉及其属支血管内静脉压升高．其中门静脉系统的胃冠状静脉与腔静脉系的食管静脉开放，展开更多
文摘In the preoperative management of congenital heart disease (CHD) with increased pulmonary blood flow, hypoxic gas management to control pulmonary blood flow is useful. However, the cerebral oxygenation state has rarely been studied, and there is concern about neurologic development. In eight infants with CHD accompanied by increased pulmonary blood flow,hypoxia was induced after a 1-h baseline period in room air (FiO2, 0.21). The infants were simultaneously monitored in both the fronttemporal region and the right-brachial region for 90 min using near-infrared spectroscopy (NIRS). The minimum SaO2 (pulse oximetry) after hypoxic gas administration was 80.8 ± 2.9% when the minimum FiO2 was 16.2 ± 1.1% . With a decrease in SaO2, oxy-Hb (O2Hb) decreased and total Hb cHb: O2Hb + deoxy-Hb (HHb) increased in both regions in the majority of infants. HHb increased in both regions with a decrease in SaO2. The maximum change in the tissue oxygenation index (TOI:O2Hb/cHb × 100) was -8.3 ± 2.6% in the front-temporal region and -3.6 ± 2.3% in the right-brachial region. Cerebral oxygenation decreased despite an increase in cerebral blood flow during hypoxic gas management. The change in TOI was ≤ 10% when the SaO2 was ≥ 80% . Safer control of SaO2 should be maintained over 80% for hypoxia management in CHD based on the results of the present study.
