Electrical bioimpedance measurement and near-infrared spectroscopy in pediatric postoperative neurocritical care: a prospective observational study

作者全名："Wang, Chenhao; Xing, Dianwei; Zhou, Shuoyan; Fang, Fang; Fu, Yueqiang; Xu, Feng"

作者地址："[Wang, Chenhao; Xing, Dianwei; Zhou, Shuoyan; Fang, Fang; Fu, Yueqiang; Xu, Feng] Chongqing Med Univ, Dept Crit Care Med, Childrens Hosp, Chongqing, Peoples R China; [Wang, Chenhao; Xing, Dianwei; Zhou, Shuoyan; Fang, Fang; Fu, Yueqiang; Xu, Feng] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China; [Wang, Chenhao; Xing, Dianwei; Zhou, Shuoyan; Fang, Fang; Fu, Yueqiang; Xu, Feng] Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Wang, Chenhao; Xing, Dianwei; Zhou, Shuoyan; Fang, Fang; Fu, Yueqiang; Xu, Feng] Chongqing Key Lab Pediat, Chongqing, Peoples R China"

通信作者："Fang, F; Xu, F (通讯作者)，Chongqing Med Univ, Dept Crit Care Med, Childrens Hosp, Chongqing, Peoples R China.; Fang, F; Xu, F (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China.; Fang, F; Xu, F (通讯作者)，Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China.; Fang, F; Xu, F (通讯作者)，Chongqing Key Lab Pediat, Chongqing, Peoples R China."

来源：FRONTIERS IN NEUROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001022102200001

JCR分区：Q2

影响因子：2.7

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：pediatric brain injury; brain edema; electrical bioimpedance; disturbance coefficient (DC); near-infrared spectroscopy (NIRS); regional cerebral oxygen saturation (rSO(2))

摘要："BackgroundTo investigate the clinical significance of the disturbance coefficient (DC) and regional cerebral oxygen saturation (rSO(2)) as obtained through the use of electrical bioimpedance and near-infrared spectroscopy (NIRS) in pediatric neurocritical care. Participants and methodsWe enrolled 45 pediatric patients as the injury group and 70 healthy children as the control group. DC was derived from impedance analysis of 0.1 mA-50 kHz current via temporal electrodes. rSO(2) was the percentage of oxyhemoglobin measured from reflected NIR light on the forehead. DC and rSO(2) were obtained at 6, 12, 24, 48 and 72 h after surgery for the injury group and during the health screening clinic visit for the control group. We compared DC and rSO(2) between the groups, their changes over time within the injury group and their correlation with intracranial pressure (ICP), cerebral perfusion pressure (CPP), Glasgow coma scale (GCS) score, Glasgow outcome scale (GOS) score, and their ability to diagnose postoperative cerebral edema and predict poor prognosis. ResultsDC and rSO(2) were significantly lower in the injury group than in the control group. In the injury group, ICP increased over the monitoring period, while DC, CPP and rSO(2) decreased. DC was negatively correlated with ICP and positively correlated with GCS score and GOS score. Additionally, lower DC values were observed in patients with signs of cerebral edema, with a DC value of 86.5 or below suggesting the presence of brain edema in patients aged 6-16 years. On the other hand, rSO(2) was positively correlated with CPP, GCS score, and GOS score, with a value of 64.4% or below indicating a poor prognosis. Decreased CPP is an independent risk factor for decreased rSO(2). ConclusionDC and rSO(2) monitoring based on electrical bioimpedance and near-infrared spectroscopy not only reflect the degree of brain edema and oxygenation, but also reflect the severity of the disease and predict the prognosis of the patients. This approach offers a real-time, bedside, and accurate method for assessing brain function and detecting postoperative cerebral edema and poor prognosis."

基金机构：Key Project of the Technology Innovation and Application Development Program of Chongqing [cstc2020jscx-sbqw0006]; National Clinical Research Center for Child Health and Disorders of China [NCRCCHD-2020-GP-08]; Natural Science Foundation Project of Chongqing of China [cstc2020jcyj-msxmX1087]

基金资助正文："This research was funded by the Key Project of the Technology Innovation and Application Development Program of Chongqing (cstc2020jscx-sbqw0006), the Project of the National Clinical Research Center for Child Health and Disorders of China (NCRCCHD-2020-GP-08) and the Natural Science Foundation Project of Chongqing of China (cstc2020jcyj-msxmX1087)."