Oxymétrie pulsée : contribution au diagnostic et à l’approche hémodynamique en pédiatrie View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-01

AUTHORS

S. Durand, J. Baleine, J. Le Bouhellec, C. Milési, R. Mesnage, G. Cambonie

ABSTRACT

L’oxymétrie de pouls est utilisée en pédiatrie depuis presque 30 ans, pour surveiller la fonction respiratoire et ajuster l’oxygénothérapie. Des avancées technologiques dans le traitement du signal pléthysmographique suggèrent un intérêt potentiel pour l’évaluation hémodynamique. L’indice de perfusion périphérique (IP), qui évalue le contingent pulsatile du signal, est proposé comme indicateur continu et non invasif de la circulation distale. Son utilisation clinique a surtout été développée en néonatalogie, comme aide au diagnostic ou complément à l’exploration de la macrocirculation. Dans la perspective d’un dépistage de cardiopathie, une valeur seuil < 0,70 est évocatrice d’une obstruction critique sur la voie d’éjection ventriculaire gauche. Chez le nouveau-né prématuré, plusieurs observations soulignent sa pertinence pour le diagnostic de bas débit systématique ou de persistance du canal artériel. Les indices dérivés de la variabilité respiratoire de la pléthysmographie de l’oxymètre ont fait principalement l’objet de travaux chez l’enfant, au bloc opératoire, dans la perspective d’évaluer sa volémie et de prédire sa réponse au remplissage vasculaire. Cependant, les résultats sont contradictoires et ne permettent actuellement pas, dans ce contexte, de rationaliser l’administration de fluides avec fiabilité par l’utilisation de ces paramètres. Des études supplémentaires sont nécessaires, particulièrement en réanimation pédiatrique, pour démontrer que l’oxymétrie de pouls peut être un outil hémodynamique d’une validité comparable à celle établie en médecine intensive de l’adulte. More... »

PAGES

322-331

References to SciGraph publications

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  • Journal

    TITLE

    Médecine Intensive Réanimation

    ISSUE

    Suppl 2

    VOLUME

    24

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s13546-014-1004-8

    DOI

    http://dx.doi.org/10.1007/s13546-014-1004-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1021306361


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