Service d'Anesthésie-Réanimation, Centre Hospitalier Universitaire de Poitiers, Poitiers, France.
Br J Anaesth. 2012 Feb;108(2):316-20. doi: 10.1093/bja/aer383. Epub 2011 Dec 11.
Respiratory monitoring is standard after anaesthesia and surgery. Abnormal respiratory rate is a sensitive indicator of respiratory problems, even in patients receiving supplemental oxygen, but the best method for its continuous measurement in spontaneously breathing patients is unclear. This study compared respiratory rate assessment by capnometry using a new oxygen mask with a carbon dioxide sampling port (Capnomask(®)) and thoracic impedance pneumography with clinical measurement (used as a reference method) in extubated patients receiving supplemental oxygen.
Adult males admitted to the post-anaesthesia care unit after general anaesthesia were studied. Immediately after extubation, a Capnomask(®) connected to a capnometer was positioned appropriately. Respiratory rate was measured by visual inspection of chest movement for 1 min, by capnometry, and thoracic impedance pneumography. One set of measurements was obtained for every patient receiving supplemental oxygen at different flow rates.
Twenty men, mean (inter-quartile range) age 54 (23-66) yr and BMI 25 (21-31) kg m(-2), were studied. Compared with visual inspection, the bias and limits of agreement were 0.0 (1.0 to -1.0) bpm for the Capnomask(®) and -2.2 (2.0 to -6.5) bpm for the impedance pneumography. The accuracy of respiratory rate assessment using Capnomask(®) was not influenced by the supplemental oxygen flow rate.
In extubated patients, continuous assessment of respiratory rate with the Capnomask(®) is more accurate than by thoracic impedance pneumography even when supplemental oxygen is delivered at a high flow rate.
麻醉和手术后，呼吸监测是标准操作。呼吸频率异常是呼吸问题的敏感指标，即使在接受补充氧气的患者中也是如此，但在自主呼吸患者中连续测量呼吸频率的最佳方法尚不清楚。本研究比较了使用带有二氧化碳采样口的新型氧气面罩（Capnomask®）的呼吸频率评估与使用临床测量（作为参考方法）的胸阻抗法在接受补充氧气的拔管患者中的应用。
研究对象为全身麻醉后进入麻醉后监护病房的成年男性。拔管后立即将 Capnomask®正确放置在一个附有测二氧化碳仪的面罩上。通过观察胸部运动来测量 1 分钟的呼吸频率，使用测二氧化碳仪和胸阻抗法进行测量。对每个接受不同流量补充氧气的患者进行一组测量。
20 名男性，平均（四分位间距）年龄 54（23-66）岁，BMI 25（21-31）kg/m²。与目测法相比，Capnomask®的偏差和一致性界限为 0.0（1.0 到-1.0）bpm，而阻抗法为-2.2（2.0 到-6.5）bpm。Capnomask®评估呼吸频率的准确性不受补充氧气流速的影响。
在拔管患者中，即使以高流量输送补充氧气，使用 Capnomask®连续评估呼吸频率也比使用胸阻抗法更准确。
