摘要
目的比较先天性心脏病(简称先心病)患儿经气管导管末端穿刺法与旁气流法监测P_(ET)CO_2和PaCO_2的相关性。方法选择全麻下行先心病手术的患儿20例,男12例,女8例,年龄3~48个月,ASAⅠ~Ⅲ级。同时采取22G套管针气管导管末端穿刺持续监测(简称末端穿刺法)与旁气流法测P_(ET)CO_2。采集动脉血测PaCO_2。记录两种方法在麻醉诱导后和心肺转流(CPB)停止后的P_(ET)CO_2和桡动脉血PaCO_2,采用配对t检验及线性相关分析两者的相关性。结果末端穿刺法测得的P_(ET)CO_2在麻醉诱导后[(36.8±2.7)mm Hg vs.(32.5±1.4)mm Hg,P<0.05]以及CPB停止后[(40.8±2.5)mm Hg vs.(36.5±1.6)mm Hg,P<0.05]均明显高于旁气流法。桡动脉血PaCO_2与末端穿刺法P_(ET)CO_2的差值在麻醉诱导后[(7.1±0.7)mm Hg vs.(11.4±1.5)mm Hg,P<0.01]和CPB停止后[(9.3±1.2)mm Hg vs.(13.5±2.3)mm Hg,P<0.01]均明显低于PaCO_2与旁气流法P_(ET)CO_2的差值。麻醉诱导后和CPB停止后PaCO_2与末端穿刺法测得P_(ET)CO_2的线性确定系数(R2)分别为0.94和0.93(P<0.05),旁气流法测得的麻醉诱导后、CPB停止后P_(ET)CO_2与PaCO_2的R2分别为0.68和0.66(P<0.05)。结论在血流动力学稳定的患儿中,经22G套管针气管导管末端穿刺持续监测P_(ET)CO_2与PaCO_2的相关性更好,可准确反映机体二氧化碳分压的变化。
Objective To determine the relationship between end-tidal carbon dioxide tension（P（ET）CO2）obtained from the distal ends of the tracheal tube and arterial pressure of carbon dioxide（PaCO2） compared with the sidestream capnometer in infants with congenital heart disease.Methods Twenty infants undergoing congenital heart disease surgery,12 males and 8females,aged3-48 months,ASA physical statusⅠ-Ⅲ were enrolled.Measurements of P（ET）CO2 were obtained from the distal ends of the tracheal tube using a sterile 22 Gcatheter that was inserted into the tube and from the proximal end with a sidestream capnometer in 20 intubated infants with congenital heart disease.The data including P（ET）CO2 and the arterial PaCO2 were obtained both after the anesthesia induction and the CPB.Results The data of P（ET）CO2 obtained from the distal ends of the tracheal tube after the anesthesia induction[（36.8±2.7）mm Hg vs.（32.5±1.4）mm Hg,P〈0.05]and the CPB[（40.8±2.5）mm Hg vs.（36.5±1.6）mm Hg,P〈0.05]were both higher than those from the proximal end with a sidestream capnometer.The difference between PaCO2 and P（ET）CO2obtained from the distal ends of the tracheal tube after the induction [（7.1±0.7）mm Hg vs.（11.4±1.5）mm Hg,P〈0.01]and the CPB [（9.3±1.2）mm Hg vs.（13.5±2.3）mm Hg,P〈0.01]were significantly lower than that between PaCO2 and P（ET）CO2 obtained from the proximal end.Distal sidestream P（ET）CO2 correlated with the PaCO2（R2=0.94 after induction and R2=0.93 after the CPB,P〈0.05）.However,the proximal P（ET）CO2 with the sidestream capnometer correlated very poorly with PaCO2 whether after the induction（R2=0.68,P〈0.05）nor the CPB（R2=0.66,P〈0.05）.Conclusion We conclude that the P（ET）CO2 obtained from the distal ends of the tracheal tube provides accurate estimates of the PaCO2 in critically ill infants with congenital heart disease.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2017年第2期133-135,共3页
Journal of Clinical Anesthesiology
关键词
患儿
先天性心脏病
呼气末二氧化碳分压
Infant patients
Congenital heart disease
End-tidal carbon dioxide tension
