The value of monitoring brain oxygen saturation in children with sepsis via near infrared spectroscopy / 中国小儿急救医学

ABSTRACT

Objective To examine the changes of regional cerebral oxygen saturation ( rScO2 ) in children with sepsis via near infrared spectroscopy(NIRS),and to preliminarily explore the clinical signifi-cance of brain oxygenation change in septic children. Methods Children with sepsis who were admitted to Children's Hospital of Fudan University from August 2015 to January 2017 were selected as research objects, according to the presence of septic shock,they were divided into septic shock group and non-shock group. Children without brain damage were selected as the control group and they were healthy before. We prospec-tive monitored the rScO2 of these children after they were admitted to our hospital and recorded the physiolog-ical and biochemical indexes such as mean arterial pressure,heart rate,hemoglobin,lactate and central venous oxygen saturation ( ScvO2 ) simulataneously. We tried to find the changing rule of rScO2 and explore the relationship between rScO2 and related physiological and biochemical indexes as well as the outcome of these children. Results A total of 30 subjects were enrolled into this study, which included 17 septic shock children and 13 non-shock children,17 relatively healthy children were brought into this study as normal con-trol . The rScO2 of septic shock children were lower than those of the non-shock children and the control group in the first 96 hours after admission (P <0. 05). Although the rScO2 were still lower at the time of 144 hours,there were no statistical significance among three groups(P>0. 05). In spite of the rScO2 had no sta-tistical correlation with mean arterial pressure,heart rate,hemoglobin and lactate,there were positive correla-tion between rScO2 and ScvO2 ,the correlation coefficient was about 0. 6 to 0. 7. The higher rScO2 ,the better Glasgow Coma Scale ( GCS) ,which reflected the degree of consciousness. Although the mean rScO2 of the deaths was lower than that of the survivors in septic children,there was no statistical difference. Conclusion The rScO2 of septic shock children is lower than that of non-shock septic children. The rScO2 has no statistical correlation with indicators such as heart rate and mean arterial pressure,but it has strong positive correlation with ScvO2 . Compared with survivors,the rScO2 is lower in dead children. NIRS may be a predictive factor in children with sepsis.