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在接受治疗性低温的婴儿中,通过皮肤注射二氧化碳与P_aCO之间的精度

Pranav Garlapati¹, Payam Vali¹, Satyan Lakshminrusimha¹

¹Dr Garlapati is affiliated with Newborn Specialists of Tulsa, Tulsa, Oklahoma. Drs Vali and Lakshminrusimha are affiliated with Department of Pediatrics, UC Davis Medical Center, Sacramento, California. Mr Smith is affiliated with Department of Respiratory Care, UC Davis Medical Center, Sacramento, California. Dr Zavorsky is affiliated with Department of Physiology and Membrane Biology, University of California, Davis, Sacramento, California.

Respiratory care

|May 30, 2023

概括

通过皮肤进行的CO2监测显示,在接受治疗性低温症的新生儿中,估计PaCO2的准确性不佳. 这种非侵入性工具可能不适合在这个脆弱的患者群体中趋势或估计二氧化碳水平.

科学领域:

新生儿医学新生儿医学
呼吸系统生理学呼吸系统生理学
医疗器械技术医疗器械技术

背景情况:

婴儿的低氧性缺血性脑病变 (HIE) 通常需要治疗性低温和高频通风.
治疗性低温期间动脉二氧化碳 (PaCO2) 的波动与不良的神经发育结果相关.
通过皮肤进行的CO2 (PtcCO2) 监测器提供了一种非侵入性的方法来估计PaCO2.

研究的目的:

在接受治疗性低温的新生儿中,与动脉CO2 (PaCO2) 相比,评估通过皮肤测量CO2 (PtcCO2) 的精度.
为了确定PtcCO2是否是PaCO2在这种特定的临床环境中可靠的非侵入性估计.

主要方法:

对接受治疗性低温和呼吸支持的10名新生儿的回顾性图表审查.
使用线性混合效应模型和布兰德-阿尔特曼图表对PtcCO2和PaCO2同时测量的分析.
分析了每个新生儿的多个配对测量 (2-27) 以评估一致性.

主要成果:

线性混合效应模型表明PtcCO2和PaCO2之间没有显著的系统差异 (95% CI的平均差异: -2.3到5.7 mm Hg,P = .41).
然而,精度很差,在95%的观察中,PtcCO2值与PaCO2的偏差超过18mmHg (高) 到13mmHg (低).
这种广泛的变化表明单个测量的精度有限.

结论:

通过皮肤进行的CO2监测显示,在治疗性低温期间,新生儿估计PaCO2的准确性不佳.
显著的变化表明PtcCO2可能不是这个群体中可靠的趋势工具.
目前的透皮CO2监测技术可能不适合在接受治疗性低温症的新生儿中准确估计PaCO2.

关键词:

血液气体分析血液气体分析血气监测血气监测血气监测血气监测导致低温引起的低温.婴儿婴儿婴儿婴儿婴儿婴儿婴儿新生儿新生儿的新生儿统计统计统计统计统计通过皮肤通过皮肤.

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