Fanconi S, Burger R, Maurer H, Uehlinger J, Ghelfi D, Mühlemann C
Department of Pediatrics, University of Zürich, Switzerland.
J Pediatr. 1990 Nov;117(5):701-5. doi: 10.1016/s0022-3476(05)83324-4.
In a prospective investigation of 17 children with severe croup, we analyzed the effect of epinephrine inhalations and mild sedation with chloral hydrate on transcutaneous carbon dioxide pressure (tcPCO2), pulse oximetry measurements, and croup scores. There was a highly significant reduction (p less than 0.001) in the tcPCO2 values and croup scores after inhalation of epinephrine. The changes in the tcPCO2 values correlated with the clinical findings. Mild sedation also significantly improved the croup scores but failed to influence the tcPCO2 values. There was not statistically significant difference in pulse oximetry saturation, fraction of administered oxygen, heart rate, or respiratory rate before and after inhalation of epinephrine or chloral hydrate administration. Monitoring tcPCO2 appears to be a reliable and objective tool for managing patients with upper airway obstruction, whereas croup scores may be misleading.
在一项针对17名重症哮吼患儿的前瞻性研究中，我们分析了肾上腺素吸入以及水合氯醛轻度镇静对经皮二氧化碳分压（tcPCO2）、脉搏血氧饱和度测量值和哮吼评分的影响。吸入肾上腺素后，tcPCO2值和哮吼评分显著降低（p小于0.001）。tcPCO2值的变化与临床结果相关。轻度镇静也显著改善了哮吼评分，但未能影响tcPCO2值。吸入肾上腺素或给予水合氯醛前后，脉搏血氧饱和度、吸氧分数、心率或呼吸频率无统计学显著差异。监测tcPCO2似乎是管理上呼吸道梗阻患者的可靠且客观的工具，而哮吼评分可能会产生误导。
