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[麻醉期间动脉-呼气末二氧化碳分压差值]

[The arterial-end tidal CO2 partial pressure difference during anesthesia].

作者信息

Frei F J, Konrad R

机构信息

Department für Anaesthesie, Universität Basel, Schweiz.

出版信息

Anaesthesist. 1990 Feb;39(2):101-6.

PMID:2106805
Abstract

Arterial CO2 partial pressure (PaCO2) can be continuously and noninvasively estimated by monitoring end-tidal CO2 partial pressure (PetCO2). However, the difference between the two (P(a-et)CO2) may vary considerably between patients. In 26 patients undergoing general anesthesia for various surgical procedures, P(a-et)CO2 was measured. We tested the hypothesis that certain clinical characteristics are associated with higher P(a-et)CO2 values in a given patient. In addition, we tested the hypothesis that P(a-et)CO2 remains constant during anesthesia by comparing the mean of eight P(a-et)CO2 values, which were measured at 15-min intervals, with the initial (P(a-et)CO2 value. Impaired lung function, defined as a lung score above 6, age above 50 years, and overweight (defined as greater than 120% of ideal body weight) were associated with increased P(a-et)CO2 (mean +/- SD: 6.27 +/- 1.85; 5.27 +/- 2.11; and 6.19 +/- 1.95 mmHg respectively) when compared to normal lung function (lung score less than or equal to 6), age below 50 years, and normal weight (less than 120% of ideal body weight, 3.87 +/- 2.31; 3.55 +/- 2.58; and 3.77 +/- 2.25 respectively). Although these differences are statistically significant, the standard deviations are large and do not allow the prediction of P(a-et)CO2 in a given patient. Initial P(a-et)CO2 correlated well with subsequent P(a-et)CO2 (R = 0.91, P less than 0.001). The mean difference of the subsequent P(a-et)CO2 values from the initial values was 0.05 +/- 0.80 mmHg (mean +/- SD) and was not significantly different from zero. In the patient population studied, P(a-et)CO2 thus remained generally constant during anesthesia.

摘要

通过监测呼气末二氧化碳分压(PetCO2),可以连续且无创地估计动脉血二氧化碳分压(PaCO2)。然而,两者之间的差值(P(a-et)CO2)在患者之间可能有很大差异。在26例接受各种外科手术全身麻醉的患者中,测量了P(a-et)CO2。我们检验了这样的假设:特定的临床特征与特定患者较高的P(a-et)CO2值相关。此外,我们通过比较以15分钟间隔测量的8个P(a-et)CO2值的平均值与初始(P(a-et)CO2值,检验了P(a-et)CO2在麻醉期间保持恒定的假设。与肺功能正常(肺评分小于或等于6)、年龄小于50岁和体重正常(小于理想体重的120%)相比,肺功能受损(定义为肺评分高于6)、年龄大于50岁和超重(定义为大于理想体重的120%)与P(a-et)CO2升高相关(平均值±标准差:分别为6.27±1.85;5.27±2.11;和6.19±1.95 mmHg)(分别为3.87±2.31;3.55±2.58;和3.77±2.25)。尽管这些差异具有统计学意义,但标准差较大,无法预测特定患者的P(a-et)CO2。初始P(a-et)CO2与随后的P(a-et)CO2相关性良好(R = 0.91,P < 0.001)。随后的P(a-et)CO2值与初始值的平均差值为0.05±0.80 mmHg(平均值±标准差),与零无显著差异。因此,在所研究的患者群体中,P(a-et)CO2在麻醉期间总体上保持恒定。

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