[一氧化碳中毒院前管理中呼出气一氧化碳的测定]

Lapostolle F, Raynaud P J, Le Toumelin P, Benaissa A, Agostinucci J M, Adnet F, Fleury M, Lapandry C

Samu 93, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny, France.

Ann Fr Anesth Reanim. 2001 Jan;20(1):10-5. doi: 10.1016/s0750-7658(00)00340-3.

INTRODUCTION

Carbon monoxide detectors are currently used by the French prehospital medical teams. These detectors can also be used to measure expired breath carbon monoxide concentration. The interest of this measurement has never been studied.

OBJECTIVE

To evaluate interest of expired breath carbon monoxide concentration measurement in the management of prehospital carbon monoxide intoxication.

STUDY DESIGN

Patients with carbon monoxide poisoning were included during 1998.

PATIENTS AND METHODS

Four levels of clinical severity: no symptom, minor, medium or severe intoxication were defined. Carbon monoxide concentration were measured in the expired breath (COHbe) at the place of the intoxication and in blood samples collected at the place of the intoxication (COHbs) and at the hospital (COHbh).

RESULTS

209 patients were included, 144 had no symptom (55%), the value of COHbe was 11.6 +/- 7.5% (mean +/- DS) and the value of COHbh was 4.9 +/- 3.3%. 91 patients had minor intoxication (35%), the value of COHbe was 16.4 +/- 7.9% and the value of COHbh was 7.1 +/- 4.5%, 21 patients had sever or medium intoxication (8%) the value of COHbe was 26.4 +/- 17.7% and the the value of COHbh was 12.8 +/- 9.3%. Results for COHbh were obtained for only three patients. Relationship between symptoms and expired breath carbon monoxide and relationship between symptoms and carbon monoxide blood concentration on arrival at the hospital were significant (p < 0.05).

CONCLUSION

Measurement of expired carbon monoxide concentration, easy and quick to perform is correlated with clinical severity in carbon monoxide poisoning.

引言

法国院前医疗团队目前使用一氧化碳探测器。这些探测器也可用于测量呼出气体中的一氧化碳浓度。但从未对这种测量的意义进行过研究。

目的

评估呼出气体一氧化碳浓度测量在院前一氧化碳中毒管理中的意义。

研究设计

纳入1998年一氧化碳中毒患者。

患者与方法

定义了四个临床严重程度级别：无症状、轻度、中度或重度中毒。在中毒现场测量呼出气体中的一氧化碳浓度（COHbe），并在中毒现场采集血样（COHbs）以及在医院采集血样（COHbh）进行检测。

结果

纳入209例患者，144例无症状（55%），COHbe值为11.6±7.5%（均值±标准差），COHbh值为4.9±3.3%。91例患者为轻度中毒（35%），COHbe值为16.4±7.9%，COHbh值为7.1±4.5%，21例患者为重度或中度中毒（8%），COHbe值为26.4±17.7%，COHbh值为12.8±9.3%。仅3例患者获得了COHbh的结果。症状与呼出气体一氧化碳之间的关系以及症状与入院时血液一氧化碳浓度之间的关系具有显著性（p<0.05）。