Lemus J F, Kearney T, Margulies D R, Mackenzie D J, Leyerle B J, Shabot M M
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048.
Am Surg. 1992 Dec;58(12):740-2.
The accuracy and reliability of an invasive intra-arterial oxygen sensor catheter was evaluated in 20 critically ill surgical intensive care unit (SICU) patients. All patients required continuous arterial blood pressure monitoring, at least 72 hours of ventilator support, and intermittent arterial blood gas sampling for clinical management. The intra-arterial sensor provided continuous PO2 (PsO2) values on a bedside electronic monitor. PsO2 values were sampled every 60 seconds and automatically stored on a bedside personal computer. Arterial blood gas (ABG) PaO2 values were collected and matched by collection time with corresponding PsO2 values. During 1,238 hours of continuous intra-arterial monitoring, 74,280 PsO2 values and 246 ABG PaO2 values were collected. Of the 246 PaO2 results, 175 (71.3%) had a matching PsO2. Regression of matched PsO2 and PaO2 values yielded a correlation coefficient of 0.58 and standard error of the estimate (SEE) of 33.1 (P < 0.0005). Even though matched PsO2 and PaO2 measurements demonstrated a linear relationship, only 34 per cent of the variation in PsO2 could be attributed to changes in PaO2. Technical sensor or instrument problems affected PsO2 monitoring in 17 of 20 patients and 28 of the 33 sensors tested. The authors conclude that continuous intra-arterial monitoring of PsO2 is a novel idea, but technical issues limit its use in acutely ill, conscious SICU patients.
在20名外科重症监护病房(SICU)的重症患者中,对一种有创动脉内氧传感器导管的准确性和可靠性进行了评估。所有患者都需要持续进行动脉血压监测、至少72小时的呼吸机支持以及为临床管理进行间歇性动脉血气采样。动脉内传感器在床边电子监测仪上提供连续的PO2(PsO2)值。每60秒采集一次PsO2值,并自动存储在床边个人计算机上。收集动脉血气(ABG)的PaO2值,并按采集时间与相应的PsO2值进行匹配。在1238小时的连续动脉内监测期间,共收集了74280个PsO2值和246个ABG PaO2值。在246个PaO2结果中,175个(71.3%)有匹配的PsO2。匹配的PsO2和PaO2值的回归分析得出相关系数为0.58,估计标准误差(SEE)为33.1(P<0.0005)。尽管匹配的PsO2和PaO2测量显示出线性关系,但PsO2变化中只有34%可归因于PaO2的变化。技术传感器或仪器问题影响了20名患者中的17名以及所测试的33个传感器中的28个的PsO2监测。作者得出结论,连续动脉内监测PsO2是一个新颖的想法,但技术问题限制了其在急性病、清醒的SICU患者中的应用。