在无呼吸氧化氧化时,通过皮肤监测二氧化碳的局限性
Thilo Schweizer1, Volker Hartwich2, Thomas Riva1,3
1Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
PloS one
|June 1, 2023
概括
通过皮肤进行的CO2监测与在呼吸暂停氧化期间的动脉血液气体测量相比显示出显著的差异. 这些发现表明,动脉血液气体分析对于临床环境中精确的二氧化碳监测至关重要.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统生理学 呼吸系统生理学
- 医疗监测 医疗监测
背景情况:
- 高流量鼻氧化经常用于接受镇静或全身麻醉的患者.
- 在这些程序中,监测二氧化碳水平 (超) 是至关重要的.
- 通过皮肤进行的二氧化碳 (ptcCO2) 监测是一种评估二氧化碳水平的非侵入性方法.
研究的目的:
- 与动脉血液气体测量相比,研究通过皮肤进行的二氧化碳监测的准确性和一致性.
- 在呼吸暂停氧化过程中评估两种不同的穿皮CO2监测器 (TCM4和TCM5) 的可靠性.
- 为了确定ptcCO2监测是否可以在这种临床背景下取代动脉CO2监测.
主要方法:
- 一个随机对照试验的二次分析,涉及100名接受选择性手术的患者.
- 在15分钟的呼吸暂停期间,每两分钟收集ptcCO2和动脉血液气体 (ABG) 测量.
- 使用布兰德-阿尔特曼图和线性混合模型进行统计分析,以评估测量方法之间的一致性和差异.
主要成果:
- 在ABG和TCM4和TCM5测量之间观察到显著的偏差和广泛的一致性极限.
- 线性混合模型显示,两台监测器的动脉和皮肤间CO2部分压力之间存在很大的偏差.
- 在两种穿皮监测系统本身之间发现了统计学上显著的差异.
结论:
- 与动脉血液气体测量相比,通过皮肤进行的CO2监测显示出了大量的差异.
- 在呼吸暂停氧化期间,ptcCO2监测并不是ABG监测的可靠替代品.
- 动脉血液气体测量对于在动态临床情况下精确评估血液二氧化碳部分压力是必要的.
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