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[检查二氧化碳监测仪的精度]

[Checking the precision of capnometers].

作者信息

Zander R, Mertzlufft F

机构信息

Institut für Physiologie und Pathophysiologie der Johannes-Gutenberg-Universität Mainz.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 1992 Feb;27(1):42-50. doi: 10.1055/s-2007-1000250.

Abstract

Capnometry, i.e. measurement of CO2 concentration (cCO2, vol%) and calculation of the respective CO2 partial pressure (pCO2, mmHg), is simple to apply, but the user must understand its principles of operation in order to appreciate its power and its limitations. However, sidestream capnometers use to dry the humidified respired gas (37 degrees C, pH2O 47 mmHg) for methodological reasons, thus increasing pCO2 by ca. 6% which, in turn, requires correction. With infrared spectroscopy, overestimation of pCO2 in presence of N2O and underreporting of pCO2 in presence of O2 also require to be corrected. These require either knowledge of the respective gas concentrations (mainstream analyzers) or adequate (i.e. correct) measurement (some sidestream capnometers). Changes in barometric pressure (pB) must be also either known or be measured automatically. Evaluation of the precision of capnometers must therefore focus on, (1) the possible pH2O correction, (2) the possible effects exercised by O2 and N2O, and (3) the possible dependence on barometric pressure. Two mainstream (Capnolog D/Dräger; Sirecust 404-1/Siemens) and eight sidestream capnometers (AGM 1304/Brüel & Kjaer; SARAcap A. G. and SARA-trans/Biomedical Systems/Hellige; Capnomac and Normocap 200/Datex/Hoyer; CO2 Monitor/Dräger; Nellcor N-1000/Nellcor/Dräger; Multinex/Datascope) were investigated. Dry and humidified gases (37 degrees C) of defined composition in respect of CO2, O2, N2, N2O, and H2O, were used for evaluation. The results prove reproducibility of ca. =/- 1 mmHg for the 10 capnometers within the 30-50 mmHg pCO2 range.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

二氧化碳监测法,即测量二氧化碳浓度(cCO2,体积百分比)并计算相应的二氧化碳分压(pCO2,毫米汞柱),操作简单,但使用者必须了解其工作原理,才能认识到其作用和局限性。然而,出于方法学原因,旁流式二氧化碳监测仪会对加湿的呼出气体(37摄氏度,水蒸气压47毫米汞柱)进行干燥,从而使pCO2大约增加6%,这就需要进行校正。使用红外光谱法时,在一氧化二氮存在的情况下对pCO2的高估以及在氧气存在的情况下对pCO2的低估也都需要校正。这要么需要了解各自的气体浓度(主流分析仪),要么需要进行充分(即正确)的测量(一些旁流式二氧化碳监测仪)。还必须知道或自动测量大气压力(pB)的变化。因此,对二氧化碳监测仪精度的评估必须关注:(1)可能的水蒸气压校正;(2)氧气和一氧化二氮可能产生的影响;(3)可能对大气压力的依赖。研究了两台主流(Capnolog D/德尔格;Sirecustustt 404-1/西门子)和八台旁流式二氧化碳监测仪(AGM 1304/布吕尔&克雅;SARAcap A.G.和SARA-trans/生物医学系统/海力;Capnomac和Normocap 200/ Datex/霍耶;二氧化碳监测仪/德尔格;Nellcor N-1000/ Nellcor/德尔格;Multinex/ Datascope)。使用了在二氧化碳、氧气、氮气、一氧化二氮和水方面成分确定的干燥和加湿气体(37摄氏度)进行评估。结果证明,在30 - 50毫米汞柱的pCO2范围内,这10台二氧化碳监测仪的重现性约为±1毫米汞柱。 (摘要截短于250词)

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