通过皮肤和动脉测量之间的乳酸水平和二氧化碳压力差异之间的关系
Aslıhan Gürün Kaya1, Şeyda Nur Özpinar1, Miraç Öz1
1Department of Chest Disease, Ankara University Faculty of Medicine, Ankara, Türkiye.
Tuberkuloz ve toraks
|June 13, 2024
概括
在患有乳酸盐水平升高的患者中,通过皮肤对二氧化碳压力 (TcCO2) 的监测可能不可靠,这表明了低输液. 建议对这些重症监护患者进行动脉血液气体 (ABG) 分析,以准确评估TcCO2.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 生物医学工程 生物医学工程
背景情况:
- 动脉血液的部分二氧化碳压力 (PaCO2) 评估了气膜通风.
- 通过皮肤进行的二氧化碳压力 (TcCO2) 提供非侵入性监测,作为动脉血液气体分析 (ABG) 的替代方案.
- 减少组织输液与二氧化碳 (CO2) 的增加有关,可能会影响TcCO2的可靠性.
研究的目的:
- 为了评估TcCO2-PaCO2差异和乳酸盐水平之间的关系.
- 评估重症监护患者的TcCO2监测的可靠性,这些患者的乳酸水平各不相同.
主要方法:
- 来自29名接受非侵入性通风 (NIV) 的超气性呼吸衰竭患者的116个配对TcCO2和PaCO2测量的前性队列研究.
- 患者根据乳酸水平进行分类:正常 (<2 mmol/L) 和增加 (≥2 mmol/L).
- 用布兰德-阿尔特曼分析和相关性分析来评估协议和关系.
主要成果:
- 在乳酸水平和TcCO2-PaCO2差异 (r=0.79,p<0.001) 之间发现了显著的相关性.
- 在增加乳糖组 (5.17 mmHg) 与正常乳糖组 (0.66 mmHg) 相比,TcCO2和PaCO2之间的平均偏差显著更大.
- 乳酸盐水平独立地与增加的TcCO2-PaCO2差异相关 (Beta=0.875,p<0.001).
结论:
- 在患有乳酸盐水平升高的重症监护患者中,TCCO2监测可能不可靠.
- 应考虑动脉血液气体 (ABG) 分析,以准确评估低 perfusion 标志物患者的二氧化碳水平.
- 需要对特定患有输液异常的患者群体的TcCO2精度进行进一步的研究.
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