Harigae M, Hirose Y, Gamo M, Hirose M, Fujiwara C, Matsuo K
Department of Anesthesia, Kanagawa Cardiovascular and Respiratory Center, Yokohama.
Masui. 1999 Mar;48(3):289-91.
We applied a continuous intra-arterial blood gas monitoring system (Paratrend 7) to a patient with pulmonary alveolar proteinosis during pulmonary lavage. Lavage was performed under general anesthesia with one lung ventilation. We inserted the sensor of Patatrend 7 through a 20 G catheter into the radial artery, and monitored pH, PaCO2 and PaO2 continuously throughout the procedure. SpO2 and EtCO2 were also monitored. Saline 1000-1500 ml was instilled and drained repeatedly by volume limited methods. PaO2 values by Paratrend 7 increased during instillation and decreased during drainage of the irrigating fluid. In contrast, PaCO2 value by Paratrend 7 decreased slightly during instillation and increased during drainage. The change of SpO2 was almost the same as that by Paratrend 7, but the response time of pulse oxymetry was a little quicker than Paratrend 7. During the lavage procedure, respiratory and circulatory condition changed very rapidly, and it is necessary to monitor blood gas change intensively. Paratrend 7 is useful as a perioperative monitoring system, but pulse oxymetry might be sufficient during pulmonary lavage considering its cost.
我们在一位肺泡蛋白沉着症患者进行肺灌洗期间应用了一种连续动脉血气监测系统（Paratrend 7）。灌洗在全身麻醉单肺通气下进行。我们通过一根20G导管将Patatrend 7的传感器插入桡动脉，并在整个过程中持续监测pH、PaCO2和PaO2。同时也监测SpO2和EtCO2。采用容量限制法反复注入和引流1000 - 1500ml生理盐水。在注入灌洗液时，Paratrend 7测得的PaO2值升高，而在引流时降低。相比之下，Paratrend 7测得的PaCO2值在注入时略有下降，在引流时升高。SpO2的变化与Paratrend 7测得的几乎相同，但脉搏血氧饱和度的反应时间比Paratrend 7稍快。在灌洗过程中，呼吸和循环状况变化非常迅速，因此有必要密切监测血气变化。Paratrend 7作为一种围手术期监测系统是有用的，但考虑到成本，在肺灌洗期间脉搏血氧饱和度监测可能就足够了。
