Szaflarski N L, Cohen N H
Department of Physiological Nursing, University of California, San Francisco.
Heart Lung. 1991 Jul;20(4):363-72.
A major responsibility of the critical care practitioner is to assure adequate ventilation of the critically ill patient. The traditionally used methods for evaluating ventilation, such as physical examination and measurement of vital signs, are indirect. The most commonly used direct method, measurement of arterial carbon dioxide tension, is invasive and intermittent. Capnography provides the critical care practitioner with a continuous, noninvasive, and accurate assessment of ventilation. To interpret capnographic data, the practitioner must have a clear understanding of normal and abnormal patterns of carbon dioxide elimination in the lung. We review relevant respiratory physiology as a basis for understanding the value of capnography. The technology on which capnography is based is described with emphasis on methods of gas sampling, limitations of capnography, and features available on currently marketed instruments. Representative capnograms are presented and the data interpreted to enable the practitioner to determine when capnography is an appropriate monitor for the critically ill adult.
重症监护从业者的一项主要职责是确保重症患者有足够的通气。传统上用于评估通气的方法，如体格检查和生命体征测量，都是间接的。最常用的直接方法，即测量动脉二氧化碳分压，具有侵入性且是间歇性的。二氧化碳监测仪为重症监护从业者提供了对通气的连续、非侵入性且准确的评估。为了解读二氧化碳监测数据，从业者必须清楚了解肺部二氧化碳排出的正常和异常模式。我们回顾相关的呼吸生理学，作为理解二氧化碳监测仪价值的基础。描述了二氧化碳监测仪所基于的技术，重点是气体采样方法、二氧化碳监测仪的局限性以及当前市场上仪器的可用功能。展示了代表性的二氧化碳监测图并对数据进行解读，以使从业者能够确定何时二氧化碳监测仪适合用于重症成年患者的监测。
