Hirabayashi Makihiko, Fujiwara Chieko, Ohtani Norimasa, Kagawa Sohei, Kamide Masayuki
Department of Anesthesiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
J Anesth. 2009;23(2):198-202. doi: 10.1007/s00540-008-0734-z. Epub 2009 May 15.
The accuracy of monitors for measuring transcutaneous PCO2 (TcPCO2), end-tidal PCO2 (EtPCO2), and nasal EtPCO2 was evaluated.
The measuring devices included a TcPCO2 monitor (TCM3; Radiometer Trading), an EtPCO2 monitor (Ultima; Datex-Ohmeda), and a nasal EtPCO2 monitor (TG-920P; Nihon Kohden). The sensor electrode of the TCM3 TcPCO2 monitor was applied to the skin of the subject's upper arm. A sampling tube attached to the proximal end of the tracheal tube was connected to the Ultima EtPCO2 monitor. The miniature sensor of the TG-920P nasal EtPCO2 monitor was attached to the nostril. The values obtained were compared with direct measurements of arterial PCO2 (PaCO2) obtained by means of an ABL700 blood gas analyzer (Radiometer Trading) in surgically treated patients. The means +/- 2 SD of the differences between variables were calculated.
The TcPCO2 monitor (0.19 +/- 4.8 mmHg, mean +/- 2-SD) was more accurate than the EtPCO2 monitor (-4.4 +/- 6.5 mmHg, mean +/- 2-SD) in patients receiving artificial ventilation via an endotracheal tube and the TcPCO2 monitor was also more accurate than the nasal EtPCO2 monitor (-6.3 +/- 9.8 mmHg, bias +/- 2-SD) in patients breathing spontaneously.
We found that the TcPCO2 monitor was more accurate than the EtPCO2 or nasal EtPCO2 monitor in surgically treated patients.
评估用于测量经皮二氧化碳分压(TcPCO2)、呼气末二氧化碳分压(EtPCO2)和鼻腔呼气末二氧化碳分压的监测仪的准确性。
测量设备包括一台经皮二氧化碳分压监测仪(TCM3;雷度贸易公司)、一台呼气末二氧化碳分压监测仪(Ultima;Datex-Ohmeda公司)和一台鼻腔呼气末二氧化碳分压监测仪(TG-920P;日本光电)。将TCM3经皮二氧化碳分压监测仪的传感器电极贴于受试者上臂皮肤。将连接在气管导管近端的采样管与Ultima呼气末二氧化碳分压监测仪相连。将TG-920P鼻腔呼气末二氧化碳分压监测仪的微型传感器贴于鼻孔。将所获得的值与通过ABL700血气分析仪(雷度贸易公司)对手术治疗患者直接测量的动脉二氧化碳分压(PaCO2)进行比较。计算变量之间差异的均值±2标准差。
在通过气管内导管进行人工通气的患者中,经皮二氧化碳分压监测仪(0.19±4.8 mmHg,均值±2标准差)比呼气末二氧化碳分压监测仪(-4.4±6.5 mmHg,均值±2标准差)更准确;在自主呼吸的患者中,经皮二氧化碳分压监测仪也比鼻腔呼气末二氧化碳分压监测仪(-6.3±9.8 mmHg,偏差±2标准差)更准确。
我们发现,在手术治疗的患者中,经皮二氧化碳分压监测仪比呼气末二氧化碳分压监测仪或鼻腔呼气末二氧化碳分压监测仪更准确。