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在分娩第二阶段使用脉搏血氧饱和度仪监测牛胎儿。

Monitoring the bovine fetus during stage II of parturition using pulse oximetry.

作者信息

Bleul U, Kähn W

机构信息

Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8008 Zurich, Switzerland.

出版信息

Theriogenology. 2008 Feb;69(3):302-11. doi: 10.1016/j.theriogenology.2007.09.033. Epub 2007 Oct 31.

Abstract

Measurement of oxygen saturation using pulse oximetry is an established method of continuous monitoring of the well-being of the human fetus during parturition. In veterinary medicine, pulse oximetry has been used almost exclusively in intensive care and anesthesiology. The goal of the present study was to investigate the physiological changes in oxygen saturation of the bovine fetus during stage II of parturition and to determine whether the findings can be used to predict postnatal acidosis. The correlation between the oxygen saturation (SpO(2)) measured via pulse oximetry and the oxygen saturation (SaO(2)) of arterial blood measured via blood gas analysis was determined in 23 newborn calves. In addition, the oxygen saturation was monitored continuously via pulse oximetry (FSpO(2)) in 33 bovine fetuses during stage II of parturition. Correlations between the FSpO(2) values during the last 30 and 5min of stage II of parturition and the postpartum values for pH, partial pressures of oxygen and carbon dioxide, bicarbonate concentration, BE, SaO(2) and lactate concentration in arterial blood were determined. There was a high correlation between SpO(2) and SaO(2) postpartum (r=0.923). The FSpO(2) values correlated moderately with the pH and BE and weakly with the lactate concentration postpartum; calves with a pH<7.2, a BE<-3mM/L or a lactate concentration of >5.4mM/L had significantly lower FSpO(2) values than non-acidotic calves. FSpO(2) values <30% for a period of at least 2min had the highest predictive value for a calf born with a pH<7.2. Pulse oximetry is a novel method of monitoring the bovine fetus during parturition; however, technical modifications are required to improve its usefulness.

摘要

使用脉搏血氧饱和度仪测量血氧饱和度是分娩期间持续监测人类胎儿健康状况的既定方法。在兽医学中,脉搏血氧饱和度仪几乎仅用于重症监护和麻醉学。本研究的目的是调查分娩第二期牛胎儿血氧饱和度的生理变化,并确定这些发现是否可用于预测出生后酸中毒。在23头新生小牛中,测定了通过脉搏血氧饱和度仪测量的血氧饱和度(SpO₂)与通过血气分析测量的动脉血氧饱和度(SaO₂)之间的相关性。此外,在33头处于分娩第二期的牛胎儿中,通过脉搏血氧饱和度仪连续监测血氧饱和度(FSpO₂)。确定了分娩第二期最后30分钟和5分钟期间的FSpO₂值与产后动脉血的pH值、氧分压和二氧化碳分压、碳酸氢盐浓度、碱剩余、SaO₂和乳酸浓度之间的相关性。产后SpO₂与SaO₂之间存在高度相关性(r = 0.923)。FSpO₂值与产后pH值和碱剩余呈中度相关,与乳酸浓度呈弱相关;pH<7.2、碱剩余<-3 mM/L或乳酸浓度>5.4 mM/L的小牛的FSpO₂值明显低于非酸中毒小牛。FSpO₂值<30%持续至少2分钟对出生时pH<7.2的小牛具有最高的预测价值。脉搏血氧饱和度仪是监测分娩期间牛胎儿的一种新方法;然而,需要进行技术改进以提高其实用性。

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