Timmermann A, Brokmann J C, Fitzka R, Nickel E A
Abteilung Anästhesiologie und Schmerztherapie, Helios Klinikum Emil von Behring, Berlin, Deutschland.
Anaesthesist. 2012 Feb;61(2):148-55. doi: 10.1007/s00101-011-1977-x.
Expiratory carbon dioxide (CO(2)) monitoring is a valuable tool in the prehospital setting. Recent reports of misplaced endotracheal tubes in the prehospital setting make it important to ensure that tube placement is verified by CO(2) monitoring. The Euronorm 2007:1789 made provision of capnometry mandatory for all medical vehicles. However, the frequency of utilization of CO(2) monitoring after securing the airway and in patients with respiratory insufficiency is low. This article covers the terminology, physiology, technology and clinical applications of CO(2) monitoring. Monitoring of cardiac output and the efficiency of cardiopulmonary resuscitation are described and the article also highlights the importance of CO(2) monitoring in patients with severe head trauma as well as restrictive and obstructive pulmonary disorders.
呼气末二氧化碳(CO₂)监测是院前急救中的一项重要工具。近期有关院前急救中气管内导管误置的报道表明,通过CO₂监测来确认导管位置至关重要。欧洲标准2007:1789规定所有医疗车辆必须配备二氧化碳监测仪。然而,在气道固定后以及呼吸功能不全患者中,CO₂监测的使用频率较低。本文涵盖了CO₂监测的术语、生理学、技术及临床应用。文中还描述了心输出量监测和心肺复苏的效果,并强调了CO₂监测在重度颅脑损伤以及限制性和阻塞性肺部疾病患者中的重要性。