在监控麻醉护理下通过导管大动脉置换期间通过皮肤测量二氧化碳的准确性:一项前性观察研究
Yuki Okazawa1,2, Yuki Kataoka3,4,5,6, Kazuo Shindo2
1Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JPN.
Cureus
|March 8, 2024
概括
通过皮肤监测二氧化碳压力 (PtcCO2) 并不是在跨导管大动脉置换 (TAVR) 期间测量动脉二氧化碳压力 (PaCO2) 的可行的替代方案. 需要进一步的研究来评估TAVR患者的PtcCO2.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 医疗器械 医疗器械
背景情况:
- 通过皮肤进行的二氧化碳张力 (PtcCO2) 提供了非侵入性,持续的监测,与侵入性,间歇性动脉二氧化碳张力 (PaCO2) 测量不同.
- 过导管大动脉置换 (TAVR) 涉及显著的血液动力学变化,需要可靠的二氧化碳监测.
- 之前的PtcCO2研究排除了TAVR患者,突出了对这种特定人群的有用性理解的差距.
研究的目的:
- 评估PtcCO2作为PaCO2监测的非侵入性替代品,在监控麻醉护理 (MAC) 下进行输血膜TAVR期间.
- 在TAVR患者中评估PtcCO2和PaCO2测量之间的一致性.
- 为了确定PtcCO2是否可以在TAVR期间可靠地检测高PaCO2事件.
主要方法:
- 对在MAC下接受 transfemoral TAVR的患者进行前性观察性研究.
- 使用耳叶传感器同时监测PaCO2 (参考) 和PtcCO2 (索引测试).
- 布兰德-阿尔特曼分析以评估一致性,预定义的可接受的一致性极限为±6.0 mmHg.
主要成果:
- 从15名TAVR患者获得了88个配对测量结果.
- 在PtcCO2和PaCO2之间达成一致的95%极限为-4.22 mmHg和6.56 mmHg.
- PtcCO2不符合预定义的临床可接受性标准,以取代PaCO2监测.
结论:
- 在MAC下,PtcCO2测量不是PaCO2监测的合适替代品,以减少MAC下的TAVR期间高PaCO2事件.
- 这项研究重点关注了门植入前后的手术期间.
- 需要进一步的研究来探索假体门类型和气球大动脉膜整形术对TAVR中PtcCO2精度的影响.
更多相关视频
07:52Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
16.2K
06:59Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
Published on: June 3, 2018
10.6K
相关概念视频
01:17Assessment of Diffusion and Perfusion
978
Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this...
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this...
978
01:20Assessment of Ventilation I: Respiratory Rate
1.1K
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.1K