Eberhard L, Haberthür C, Fabry B, Guttmann J
Department of Internal Medicine, University Clinics Basel, Switzerland.
Technol Health Care. 1999;7(4):243-59.
In intensive care patients who receive ventilatory support or full mechanical ventilation, valuable information can be drawn from gas exchange measurements. In this setting, the most favorable method for gas exchange measurement is by simultaneous recording of gas concentrations and gas flow, and by time resolved multiplication and accumulation. This paper presents a new method to compensate for the signal delay time which occurs when a sampling capillary is used for measuring gas concentrations with a respiratory mass spectrometer or some equivalent sidestream gas analyzer. The signal delay of gas concentrations must be accurately compensated to avoid error accumulation in gas exchange calculation. A delay time can be easily measured with a test gas in a laboratory setup and be readily compensated for during the measurements in a ventilated patient. This is a standard procedure which gives reasonable results under normal conditions. Special attention is however required in cases where the gas viscosity changes due to large changes in gas composition, e.g., those used for diagnostic breathing or ventilatory maneuvers. Such changes of viscosity will influence the delay time of the capillary, because they affect its flow resistance. As a consequence they will degrade the quality of measurements when done with a simple fixed delay compensation. The method described here consists of an algorithm which enables compensation for such a temporally changing delay time due to changes in gas composition.
在接受通气支持或完全机械通气的重症监护患者中,气体交换测量可提供有价值的信息。在此情况下,气体交换测量的最有利方法是同时记录气体浓度和气体流量,并通过时间分辨乘法和累加来进行。本文提出了一种新方法,用于补偿在使用采样毛细管通过呼吸质谱仪或某些等效的旁流式气体分析仪测量气体浓度时出现的信号延迟时间。必须准确补偿气体浓度的信号延迟,以避免气体交换计算中的误差累积。在实验室设置中,使用测试气体可以轻松测量延迟时间,并在对通气患者进行测量期间很容易进行补偿。这是一个标准程序,在正常条件下能给出合理的结果。然而,在气体成分发生大幅变化(例如用于诊断性呼吸或通气操作的气体)导致气体粘度改变的情况下,需要特别注意。这种粘度变化会影响毛细管的延迟时间,因为它们会影响其流动阻力。因此,在使用简单的固定延迟补偿进行测量时,它们会降低测量质量。这里描述的方法包括一种算法,该算法能够补偿由于气体成分变化而随时间变化的延迟时间。