Rüdiger Mario, Töpfer Kerstin, Hammer Hannes, Schmalisch Gerd, Wauer Roland R
Clinic of Neonatology, Universitätsmedizin Berlin, Charité-Mitte, Germany.
BMC Pediatr. 2005 Aug 10;5:30. doi: 10.1186/1471-2431-5-30.
PCO2 and PO2 are important monitoring parameters in neonatal intensive care units (NICU). Compared to conventional blood gas measurements that cause significant blood loss in preterms, transcutaneous (tc) measurements allow continuous, non-invasive monitoring of blood gas levels. The aim of the study was to survey the usage and opinions among German speaking NICUs concerning tc blood gas monitoring.
A questionnaire was developed and sent to 56 head nurses of different NICUs in Germany, Switzerland and Austria.
A completely answered questionnaire was obtained from 41 NICUs. In two of these units tc measurements are not performed. In most NICUs (77%), both PtcO2 and PtcCO2 are measured simultaneously. Most units change the sensors every 3 hours; however, the recommended temperature of 44 degrees C is used in only 15% of units. In only 8% of units are arterial blood gases obtained to validate tc values. Large variations were found concerning the targeted level of oxygen saturation [median upper limit: 95% (range 80-100%); median lower limit: 86% (range 75-93%)] and PO2 [median upper limit: 70 mmHg (range 45-90 mmHg); median lower limit: 44 mmHg (range 30-60 mmHg)].
Our survey shows that the use of tc monitors remains widespread among German speaking NICUs, despite earlier data suggesting that their use had been abandoned in many NICUs worldwide. In addition, we suggest that the current method of monitoring oxygenation may not prevent hyperoxemia in preterm infants.
二氧化碳分压（PCO₂）和氧分压（PO₂）是新生儿重症监护病房（NICU）重要的监测参数。与导致早产儿大量失血的传统血气测量相比，经皮（tc）测量可实现对血气水平的连续、无创监测。本研究旨在调查德语区NICU对tc血气监测的使用情况和看法。
设计了一份问卷，并发送给德国、瑞士和奥地利不同NICU的56名护士长。
从41个NICU获得了完整填写的问卷。其中两个单位未进行tc测量。在大多数NICU（77%）中，同时测量经皮氧分压（PtcO₂）和经皮二氧化碳分压（PtcCO₂）。大多数单位每3小时更换一次传感器；然而，只有15%的单位使用推荐的44摄氏度温度。只有8%的单位采集动脉血气以验证tc值。在氧饱和度目标水平[中位数上限：95%（范围80 - 100%）；中位数下限：86%（范围75 - 93%）]和PO₂[中位数上限：70 mmHg（范围45 - 90 mmHg）；中位数下限：44 mmHg（范围30 - 60 mmHg）]方面发现了很大差异。
我们的调查表明，尽管早期数据表明全球许多NICU已不再使用tc监测仪，但tc监测仪在德语区NICU中仍广泛使用。此外，我们认为目前的氧合监测方法可能无法预防早产儿高氧血症。
