应用近红外光谱技术监测脓毒症患儿胃肠功能障碍的前瞻性研究

doi:10.7499/j.issn.1008-8830.2202099

Abstract
Figure/Table
References(29)
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (549 KB) HTML
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective To investigate the incidence and mortality of gastrointestinal dysfunction in children with sepsis, the application of near-infrared spectroscopy (NIRS) in monitoring mesenteric regional tissue oxygen saturation (rSO2), and the association between rSO2 and gastrointestinal dysfunction. Methods In this prospective study, 79 children with sepsis in the pediatric intensive care unit (sepsis group) and 40 children who underwent physical examination in the Department of Child Healthcare (healthy control group) from January to December, 2021 were enrolled as subjects. The related medical data were collected, including general information on admission and at discharge, treatment during hospitalization, and laboratory examination results. NIRS was used to measure mesenteric rSO2. Clinical characteristics were compared between the patients with and without gastrointestinal dysfunction. Results For the 79 children with sepsis, the incidence rate of gastrointestinal dysfunction was 49% (39/79), and the mortality rate of the children with gastrointestinal dysfunction was 26% (10/39). The children with gastrointestinal dysfunction had a longer duration of mechanical ventilation and a higher 28-day mortality rate (P<0.05). The children with gastrointestinal dysfunction had a significantly lower median rSO2 (64%) than the children without gastrointestinal dysfunction (72%) and the healthy control group (78%) (P<0.05). Conclusions There are high incidence and mortality rates of gastrointestinal dysfunction in children with sepsis, and the reduction in rSO2 may be associated with the development of gastrointestinal dysfunction.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	YAO De-Zhen
	WANG Li-Jie

Key words： Sepsis Gastrointestinal dysfunction Near-infrared spectroscopy Child

Received: 23 February 2022

Cite this article:

YAO De-Zhen,WANG Li-Jie. Monitoring of gastrointestinal dysfunction by near-infrared spectroscopy in children with sepsis: a prospective study[J]. CJCP, 2022, 24(6): 620-625.

URL:

http://www.zgddek.com/EN/10.7499/j.issn.1008-8830.2202099 OR http://www.zgddek.com/EN/Y2022/V24/I6/620

	Reintam Blaser A, Jakob SM, Starkopf J. Gastrointestinal failure in the ICU[J]. Curr Opin Crit Care, 2016, 22(2): 128-141. PMID: 26835609. DOI: 10.1097/MCC.0000000000000286.
	Klingensmith NJ, Coopersmith CM. The gut as the motor of multiple organ dysfunction in critical illness[J]. Crit Care Clin, 2016, 32(2): 203-212. PMID: 27016162. PMCID: PMC4808565. DOI: 10.1016/j.ccc.2015.11.004.
	3 章玉丹, 沙移飞, 李华, 等. 急性胃肠功能衰竭患儿急诊和治疗的临床分析[J]. 河北医药, 2017, 39(1): 113-115. DOI: 10.3969/j.issn.1002-7386.2017.01.035.
	4 中华医学会儿科学会急救学组. 第四届全国小儿急救医学研讨会纪要[J]. 中华儿科杂志, 1995, 33(6): 370-373.
	Lo MY, Ong MW, Chen WY, et al. The effects of acupuncture on cerebral and muscular microcirculation: a systematic review of near-infrared spectroscopy studies[J]. Evid Based Complement Alternat Med, 2015, 2015: 839470. PMID: 26221180. PMCID: PMC4480930. DOI: 10.1155/2015/839470.
	Gumulak R, Lucanova LC, Zibolen M. Use of near-infrared spectroscopy (NIRS) in cerebral tissue oxygenation monitoring in neonates[J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2017, 161(2): 128-133. PMID: 28360433. DOI: 10.5507/bp.2017.012.
	Goldstein B, Giroir B, Randolph A, et al. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics[J]. Pediatr Crit Care Med, 2005, 6(1): 2-8. PMID: 15636651. DOI: 10.1097/01.PCC.0000149131.72248.E6.
	Padar M, Starkopf J, Uusvel G, et al. Gastrointestinal failure affects outcome of intensive care[J]. J Crit Care, 2019, 52: 103-108. PMID: 31035184. DOI: 10.1016/j.jcrc.2019.04.001.
	Reintam A, Parm P, Kitus R, et al. Gastrointestinal failure score in critically ill patients: a prospective observational study[J]. Crit Care, 2008, 12(4): R90. PMID: 18625051. PMCID: PMC2575570. DOI: 10.1186/cc6958.
	10 季娟娟, 孙耕耘. 降钙素原和常用炎症指标在脓毒症诊断及预后中的价值[J]. 中华肺部疾病杂志(电子版), 2015, 8(4): 4-8. DOI: 10.3877/cma.j.issn.1674-6902.2015.04.002.
	Kowlgi NG, Chhabra L. D-lactic acidosis: an underrecognized complication of short bowel syndrome[J]. Gastroenterol Res Pract, 2015, 2015: 476215. PMID: 25977687. PMCID: PMC4421027. DOI: 10.1155/2015/476215.
	Kong C, Li SM, Yang H, et al. Screening and combining serum biomarkers to improve their diagnostic performance in the detection of intestinal barrier dysfunction in patients after major abdominal surgery[J]. Ann Transl Med, 2019, 7(16): 388. PMID: 31555702. PMCID: PMC6736800. DOI: 10.21037/atm.2019.07.102.
	Lei G, Zhang J, Wang X, et al. Plasma D-lactate levels in necrotizing enterocolitis in premature infants[J]. Iran J Pediatr, 2016, 26(2): e4403. PMID: 27307969. PMCID: PMC4906561. DOI: 10.5812/ijp.4403.
	Duzgun AP, Bugdayci G, Sayin B, et al. Serum D-lactate: a useful diagnostic marker for acute appendicitis[J]. Hepatogastroenterology, 2007, 54(77): 1483-1486. PMID: 17708281.
	Shi H, Wu B, Wan J, et al. The role of serum intestinal fatty acid binding protein levels and D-lactate levels in the diagnosis of acute intestinal ischemia[J]. Clin Res Hepatol Gastroenterol, 2015, 39(3): 373-378. PMID: 25683524. DOI: 10.1016/j.clinre.2014.12.005.
	Teng J, Xiang L, Long H, et al. The serum citrulline and D-lactate are associated with gastrointestinal dysfunction and failure in critically ill patients[J]. Int J Gen Med, 2021, 14: 4125-4134. PMID: 34377012. PMCID: PMC8349205. DOI: 10.2147/IJGM.S305209.
	17 彭昊, 龙博文, 肖晨, 等. 重症监护室患儿血清胃泌素和胃动素指标的变化及意义研究[J]. 中国全科医学, 2021, 24(32): 4094-4098. DOI: 10.12114/j.issn.1007-9572.2021.01.025.
	Minhua C, Tao G, Fengchan X, et al. Using digestive fluid biomarkers to predict acute gastrointestinal injury in critically ill patients: a pilot study[J]. Am J Crit Care, 2018, 27(6): 504-507. PMID: 30385542. DOI: 10.4037/ajcc2018255.
	19 唐晓梦, 任玉倩, 熊熙, 等. 成纤维细胞生长因子19预测儿童脓毒症合并胃肠功能障碍的临床价值[J]. 上海交通大学学报(医学版), 2020, 40(9): 1236-1242. DOI: 10.3969/j.issn.1674-8115.2020.09.012.
	Al Tayar A, Abouelela A, Mohiuddeen K. Can the cerebral regional oxygen saturation be a perfusion parameter in shock?[J]. J Crit Care, 2017, 38: 164-167. PMID: 27915164. DOI: 10.1016/j.jcrc.2016.11.006.
	Ghidini F, Benetti E, Zucchetta P, et al. Transcutaneous near-infrared spectroscopy (NIRS) for monitoring kidney and liver allograft perfusion[J]. Int J Clin Pract, 2021, 75(5): e14034. PMID: 33470001. DOI: 10.1111/ijcp.14034.
	Dorum BA, Ozkan H, Cetinkaya M, et al. Regional oxygen saturation and acute kidney injury in premature infants[J]. Pediatr Int, 2021, 63(3): 290-294. PMID: 32634851. DOI: 10.1111/ped.14377.
	Jones S, Chiesa ST, Chaturvedi N, et al. Recent developments in near-infrared spectroscopy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen[J]. Artery Res, 2016, 16: 25-33. PMID: 27942271. PMCID: PMC5134760. DOI: 10.1016/j.artres.2016.09.001.
	Huang J, Zhou Y, Zhu D. Systemic haemodynamics and regional tissue oxygen saturation after bidirectional cavopulmonary shunt: positive pressure ventilation versus spontaneous breathing[J]. Interact Cardiovasc Thorac Surg, 2016, 23(2): 235-239. PMID: 27165735. DOI: 10.1093/icvts/ivw126.
	Scott JP, Hoffman GM. Near-infrared spectroscopy: exposing the dark (venous) side of the circulation[J]. Paediatr Anaesth, 2014, 24(1): 74-88. PMID: 24267637. DOI: 10.1111/pan.12301.
	Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3)[J]. JAMA, 2016, 315(8): 801-810. PMID: 26903338. PMCID: PMC4968574. DOI: 10.1001/jama.2016.0287.
	Stienstra RM, McHoney M. Near-infrared spectroscopy (NIRS) measured tissue oxygenation in neonates with gastroschisis: a pilot study[J]. J Matern Fetal Neonatal Med, 2021, 1-9. PMID: 33602021. DOI: 10.1080/14767058.2021.1875429. Epub ahead of print.
	Patel AK, Lazar DA, Burrin DG, et al. Abdominal near-infrared spectroscopy measurements are lower in preterm infants at risk for necrotizing enterocolitis[J]. Pediatr Crit Care Med, 2014, 15(8): 735-741. PMID: 25068253. DOI: 10.1097/PCC.0000000000000211.
	Kaufman J, Almodovar MC, Zuk J, et al. Correlation of abdominal site near-infrared spectroscopy with gastric tonometry in infants following surgery for congenital heart disease[J]. Pediatr Crit Care Med, 2008, 9(1): 62-68. PMID: 18477915. DOI: 10.1097/01.PCC.0000298640.47574.DA.