在机械通风或正在进行的心肺复苏期间输入二碳酸后的潮尾二氧化碳
Young-Il Roh1, Hyung Il Kim2, Sun Ju Kim3
1Department of Emergency Medicine, Wonju College of Medicine Yonsei University, Wonju, Republic of Korea; Research Institute of Resuscitation Science, Wonju College of Medicine Yonsei University, Wonju, Republic of Korea.
The American journal of emergency medicine
|December 14, 2023
概括
碳酸在机械通风或心肺复苏过程中显著增加了患者的几分钟的潮尾二氧化碳水平. 这种增加可能会限制使用尾潮CO2作为一个可靠的生理指标后的管理.
科学领域:
- 关键护理医学 关键护理医学
- 生理学 生理学 生理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 潮尾二氧化碳 (EtCO2) 对于监测呼吸和血液动力学状况至关重要 在机械呼吸和心肺复苏 (CPR) 等重症监护干预期间.
- 碳酸的使用是重症监护中常见的干预措施,但其对EtCO2的影响尚未完全理解.
研究的目的:
- 为了研究在成人患者中二碳酸盐的使用后,潮尾二氧化碳 (EtCO2) 的变化.
- 为了比较自发循环 (SC) 患者和正在进行心肺复苏的患者之间的EtCO2变化的动态.
主要方法:
- 一项前性观察性研究,涉及33名成年患者在机械通风或心肺复苏期间接受二碳酸.
- 测量终潮二氧化碳 (EtCO2) 水平,包括基线,峰值,滞后时间 (Tlag),到峰值的时间 (Tpeak) 和上升的持续时间 (Tduration).
- 在SC组 (n=25) 和CPR组 (n=8) 之间的EtCO2参数的比较.
主要成果:
- 二碳酸盐的使用导致所有患者 (从21mmHg到41mmHg) 的潮末CO2峰值平均增加了100%.
- 在SC (89.5%) 和CPR (160.2%) 组中都观察到显著增加.
- 在SC和CPR组之间没有发现Tlag,Tpeak或Tduration的显著差异. 在SC组中,持续时间与二碳酸盐剂量相关.
结论:
- 二碳酸盐的使用会导致严重病情患者的潮末CO2的长期大幅增加.
- 由于二碳酸导致EtCO2的显著增加,可能会暂时限制其作为唯一生理监测参数的实用性.
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