目的探讨新生儿机械通气时呼气末二氧化碳分压(PetCO2)和动脉血二氧化碳分压(PaCO2)的相关性。方法对31例气管插管机械通气的新生儿进行持续主流PetCO2监测,并同时配对检测85例次动脉血血气分析,评估PetCO2与PaCO2的相关性和一致性。结...目的探讨新生儿机械通气时呼气末二氧化碳分压(PetCO2)和动脉血二氧化碳分压(PaCO2)的相关性。方法对31例气管插管机械通气的新生儿进行持续主流PetCO2监测,并同时配对检测85例次动脉血血气分析,评估PetCO2与PaCO2的相关性和一致性。结果 31例机械通气新生儿PetCO2均值(41±10 mm Hg)低于PaCO2均值(46±11 mm Hg)(P<0.01),二者具有显著正相关性(r=0.92,P<0.01);平均偏倚是5.1±4.3 mm Hg,在95%一致性范围是(-3.3,13.6 mm Hg),5%(4/85)的数值在95%的可信区间以外。在氧合指数(OI)<300 mm Hg(n=48)时,PetCO2和PaCO2具有显著正相关性(r=0.85,P<0.01),平均偏倚是5.9±4.3 mm Hg,在95%一致性范围是(-2.6,14.5 mm Hg),4%(2/48)的数值在95%的可信区间以外。OI≥300 mm Hg(n=37)时,PetCO2和PaCO2也有显著正相关性(r=0.91,P<0.01),平均偏倚是4.1±4.1 mm Hg,在95%一致性范围是(-3.9,12.1 mm Hg),仅5%(2/37)的数值在95%的可信区间以外。结论在机械通气的新生儿中,PetCO2和PaCO2有较好的相关性和一致性。展开更多
Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in ob...Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in obese patients during general anesthesia. Materials and Methods: From January 2003 to December 2013, we studied 601 patients aged 16 years old or over undergoing general anesthesia. Patients had American Society of Anesthesiology physical status I and II and we reviewed their anesthetic charts. The P(a-ET)CO2 with respect to the BKI divided patients into two groups: 16 to 2 values between the two groups. Results: In patients aged 16 to 2 was 2.2 ± 3.1 mmHg at BKI 2 was 3.2 ± 4.1 mmHg at BKI 2 tends to increase in obese patients during general anesthesia with increasing BKI in patients aged 16 to < 65 years old.展开更多
目的:分析不同血循环状态下经皮氧分压(transcutaneous oxygen pressure,PctO_2)与血氧分压(partial pressure of oxygen in arterial blood,PaO_2)、经皮二氧化碳分压(transcutaneous carbon dioxide pressure,PctCO_2)与血二氧化碳分...目的:分析不同血循环状态下经皮氧分压(transcutaneous oxygen pressure,PctO_2)与血氧分压(partial pressure of oxygen in arterial blood,PaO_2)、经皮二氧化碳分压(transcutaneous carbon dioxide pressure,PctCO_2)与血二氧化碳分压(partial pressure of oxygen in arterial blood,PaCO_2)的相关性及差异性,从而了解PctO_2及PctCO_2在微循环障碍时的监测意义。方法:对2014年11月至2015年3月在重庆医科大学附属儿童医院重症医学科住院的56例患儿进行PctO_2/PctCO_2监测,因病情需要,部分患儿不同时段予动态监测,共采集110份数据。分析微循环正常组(n=75)、轻度障碍组(n=20)及重度障碍组(n=15)间PctO_2与PaO_2及PctCO_2与PaCO_2的相关性及差异性。用受试者工作特征曲线(receiver operating characteristics curve,ROC curve)评价PctO_2、PctCO_2诊断低氧血症及二氧化碳潴留的敏感度及特异度。结果:相关性分析:在微循环正常组(n=75),PctO_2与PaO_2、PctCO_2与PaCO_2均有良好相关性(r=0.937、0.569,均P<0.05);在微循环轻度障碍组(n=20)及重度障碍组(n=15),患儿PctCO_2与PaCO_2均具有良好的相关性(r=0.718、0.679,均P<0.05),而PctO_2与PaO_2无相关性(P=0.175、0.074)。氧分压差(△PO2):微循环正常组(n=75)、轻度障碍组(n=20)和重度障碍组(n=15)的△PO2分别为:(0.24±1.08)、(7.99±7.99)和(9.71±5.15)k Pa。ROC曲线分析:微循环正常组(n=75)中,PctO_2在ROC曲线下面积(area under the ROC curve,AUC)为0.89(95%CI=0.82~0.96,P=0.036),PctO_2=10.25 k Pa时诊断缺氧的敏感度是81.5%,特异度是83.3%。PctCO_2的AUC为0.77(95%CI=0.65~0.88,P=0.000),PctCO_2=5.45 k Pa时诊断二氧化碳潴留的敏感度是81.5%,特异度是66.7%。结论:在微循环正常时,PctO_2/PctCO_2监测在一定程度上可预测PaO_2/PaCO_2。在微循环轻度障碍及重度障碍时,PctCO_2监测可预测PaCO_2。PctO_2与PaO_2差别明显时往往提示微循环灌注不良,对于此类危重症患者,可结合PctO_2/PctCO_2监测与血气分析�展开更多
文摘目的探讨新生儿机械通气时呼气末二氧化碳分压(PetCO2)和动脉血二氧化碳分压(PaCO2)的相关性。方法对31例气管插管机械通气的新生儿进行持续主流PetCO2监测,并同时配对检测85例次动脉血血气分析,评估PetCO2与PaCO2的相关性和一致性。结果 31例机械通气新生儿PetCO2均值(41±10 mm Hg)低于PaCO2均值(46±11 mm Hg)(P<0.01),二者具有显著正相关性(r=0.92,P<0.01);平均偏倚是5.1±4.3 mm Hg,在95%一致性范围是(-3.3,13.6 mm Hg),5%(4/85)的数值在95%的可信区间以外。在氧合指数(OI)<300 mm Hg(n=48)时,PetCO2和PaCO2具有显著正相关性(r=0.85,P<0.01),平均偏倚是5.9±4.3 mm Hg,在95%一致性范围是(-2.6,14.5 mm Hg),4%(2/48)的数值在95%的可信区间以外。OI≥300 mm Hg(n=37)时,PetCO2和PaCO2也有显著正相关性(r=0.91,P<0.01),平均偏倚是4.1±4.1 mm Hg,在95%一致性范围是(-3.9,12.1 mm Hg),仅5%(2/37)的数值在95%的可信区间以外。结论在机械通气的新生儿中,PetCO2和PaCO2有较好的相关性和一致性。
文摘Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in obese patients during general anesthesia. Materials and Methods: From January 2003 to December 2013, we studied 601 patients aged 16 years old or over undergoing general anesthesia. Patients had American Society of Anesthesiology physical status I and II and we reviewed their anesthetic charts. The P(a-ET)CO2 with respect to the BKI divided patients into two groups: 16 to 2 values between the two groups. Results: In patients aged 16 to 2 was 2.2 ± 3.1 mmHg at BKI 2 was 3.2 ± 4.1 mmHg at BKI 2 tends to increase in obese patients during general anesthesia with increasing BKI in patients aged 16 to < 65 years old.
文摘目的:分析不同血循环状态下经皮氧分压(transcutaneous oxygen pressure,PctO_2)与血氧分压(partial pressure of oxygen in arterial blood,PaO_2)、经皮二氧化碳分压(transcutaneous carbon dioxide pressure,PctCO_2)与血二氧化碳分压(partial pressure of oxygen in arterial blood,PaCO_2)的相关性及差异性,从而了解PctO_2及PctCO_2在微循环障碍时的监测意义。方法:对2014年11月至2015年3月在重庆医科大学附属儿童医院重症医学科住院的56例患儿进行PctO_2/PctCO_2监测,因病情需要,部分患儿不同时段予动态监测,共采集110份数据。分析微循环正常组(n=75)、轻度障碍组(n=20)及重度障碍组(n=15)间PctO_2与PaO_2及PctCO_2与PaCO_2的相关性及差异性。用受试者工作特征曲线(receiver operating characteristics curve,ROC curve)评价PctO_2、PctCO_2诊断低氧血症及二氧化碳潴留的敏感度及特异度。结果:相关性分析:在微循环正常组(n=75),PctO_2与PaO_2、PctCO_2与PaCO_2均有良好相关性(r=0.937、0.569,均P<0.05);在微循环轻度障碍组(n=20)及重度障碍组(n=15),患儿PctCO_2与PaCO_2均具有良好的相关性(r=0.718、0.679,均P<0.05),而PctO_2与PaO_2无相关性(P=0.175、0.074)。氧分压差(△PO2):微循环正常组(n=75)、轻度障碍组(n=20)和重度障碍组(n=15)的△PO2分别为:(0.24±1.08)、(7.99±7.99)和(9.71±5.15)k Pa。ROC曲线分析:微循环正常组(n=75)中,PctO_2在ROC曲线下面积(area under the ROC curve,AUC)为0.89(95%CI=0.82~0.96,P=0.036),PctO_2=10.25 k Pa时诊断缺氧的敏感度是81.5%,特异度是83.3%。PctCO_2的AUC为0.77(95%CI=0.65~0.88,P=0.000),PctCO_2=5.45 k Pa时诊断二氧化碳潴留的敏感度是81.5%,特异度是66.7%。结论:在微循环正常时,PctO_2/PctCO_2监测在一定程度上可预测PaO_2/PaCO_2。在微循环轻度障碍及重度障碍时,PctCO_2监测可预测PaCO_2。PctO_2与PaO_2差别明显时往往提示微循环灌注不良,对于此类危重症患者,可结合PctO_2/PctCO_2监测与血气分析�
