Weiss Markus, Schmitz Achim, Salgo Bettina, Dullenkopf Alexander
Department of Anaesthesia, University Children's Hospital, Steinwiesstrasse 75, CH-8032, Zurich, Switzerland.
J Anesth. 2006;20(3):243-6. doi: 10.1007/s00540-006-0410-0.
Rectal luminal regional P(CO2) (Pr(CO2)) was compared with gastric luminal Pr(CO2) measured by automated air tonometry at intervals of 10 min in 20 children aged 6-16 years scheduled for elective surgery under general anesthesia. In 5 patients, measurement of rectal Pr(CO2) failed because of catheter-related problems. In the remaining 15 children, aged 10.6 +/- 2.5 years, 19 +/- 7 paired rectal and gastric Pr(CO2) values (n total, 241) were measured. Bias and precision for gastric compared to rectal Pr(CO2) was -1.79 kPa and 2.89 kPa. In patients with obvious feces in the rectum, bias (precision) for gastric compared to rectal Pr(CO2) was -2.7 kPa (2.6 kPa) and in those with empty rectum, -0.75 kPa (1.42 kPa; t-test; P < 0.001). Based on our in vivo data, rectal luminal Pr(CO2), measured by automated air tonometry, does not reflect gastric luminal Pr(CO2) in children. Enteral luminal gas production within feces in the rectum seems to be a major source of this disagreement.
对20名年龄在6至16岁、计划接受全身麻醉下择期手术的儿童，每隔10分钟使用自动气眼压计比较直肠腔内局部P(CO2)（Pr(CO2)）与胃腔内Pr(CO2)。5例患者因导管相关问题未能测量直肠Pr(CO2)。其余15名儿童，年龄为10.6±2.5岁，测量了19±7对直肠和胃Pr(CO2)值（共241个）。与直肠Pr(CO2)相比，胃Pr(CO2)的偏差和精密度分别为-1.79 kPa和2.89 kPa。直肠内有明显粪便的患者，与直肠Pr(CO2)相比，胃Pr(CO2)的偏差（精密度）为-2.7 kPa（2.6 kPa），直肠排空的患者为-0.75 kPa（1.42 kPa；t检验；P<0.001）。根据我们的体内数据，通过自动气眼压计测量的直肠腔内Pr(CO2)不能反映儿童胃腔内Pr(CO2)。直肠内粪便中的肠腔内气体产生似乎是这种差异的主要来源。
