Sebbane Mustapha, Claret Pierre-Géraud, Jreige Riad, Dumont Richard, Lefebvre Sophie, Rubenovitch Josh, Mercier Grégoire, Eledjam Jean-Jacques, de la Coussaye Jean-Emmanuel
Département des urgences, Centre Hospitalier Régional Universitaire Lapeyronie, Montpellier, France.
J Emerg Med. 2012 Oct;43(4):747-53. doi: 10.1016/j.jemermed.2011.06.147. Epub 2012 Mar 8.
Acute alcohol intoxication is a frequent cause of emergency department (ED) visits. Evaluating a patient's alcohol intoxication is commonly based on both a physical examination and determination of blood alcohol concentration (BAC).
To demonstrate the feasibility and usefulness of using a last-generation infrared breath analyzer as a non-invasive and rapid screening tool for alcohol intoxication in the ED.
Adult patients suspected of acute alcohol intoxication were prospectively enrolled over 10 days. Breath alcohol concentrations (BrAC) were measured using a handheld infrared breath analyzer. BAC was determined simultaneously by automated enzymatic analysis of a venous blood sample. The relationship between BAC and BrAC values was examined by both linear regression and Bland-Altman analysis.
The study included 54 patients (mean age 40±14 years, sex ratio M/F of 3/1). Breath and blood alcohol concentrations ranged from 0 to 1.44 mg/L and from 0 to 4.40 g/L (0-440 mg/dL), respectively. The mean individual BAC/BrAC ratio was 2615±387, 95% confidence interval 2509-2714, which is 30% higher than the legal ratio in France (2000). The correlation between both measurements was excellent: r=0.95 (0.92-0.97). Linear regression revealed BAC=0.026+1.29 (BrAC×2000) and BAC=0.026+0.99 (BrAC×2615). Mean BAC-BrAC differences and limits of agreement were 0.49 g/L [-0.35, 1.34] (or 49 mg/dL [-35, 134] and 0.01 g/L [-0.68, 0.71] (or 1 mg/dL [-68, 71]), for the 2000 and 2615 ratios, respectively.
The calculated conversion coefficient provided a satisfactory determination of blood alcohol concentration. Breath alcohol testing, using appropriate BAC/BrAC conversion, different from the legal BAC/BrAC, could be a reliable alternative for routine screening and management of alcohol intoxication in the ED.
急性酒精中毒是急诊科就诊的常见原因。评估患者的酒精中毒情况通常基于体格检查和血液酒精浓度（BAC）测定。
证明使用新一代红外呼气分析仪作为急诊科酒精中毒的非侵入性快速筛查工具的可行性和实用性。
前瞻性纳入10天内疑似急性酒精中毒的成年患者。使用手持式红外呼气分析仪测量呼气酒精浓度（BrAC）。同时通过对静脉血样本进行自动酶分析来测定BAC。通过线性回归和布兰德-奥特曼分析检查BAC与BrAC值之间的关系。
该研究纳入了54例患者（平均年龄40±14岁，男女比例为3/1）。呼气和血液酒精浓度分别为0至1.44mg/L和0至4.40g/L（0 - 440mg/dL）。个体平均BAC/BrAC比值为2615±387，95%置信区间为2509 - 2714，比法国法定比值（2000）高30%。两种测量方法之间的相关性极佳：r = 0.95（0.92 - 0.97）。线性回归显示BAC = 0.026 + 1.29（BrAC×2000）和BAC = 0.026 + 0.99（BrAC×2615）。对于2000和2615的比值，平均BAC - BrAC差值及一致性界限分别为0.49g/L [-0.35, 1.34]（或49mg/dL [-35, 134]）和0.01g/L [-0.68, 0.71]（或1mg/dL [-68, 71]）。
计算出的转换系数能令人满意地测定血液酒精浓度。使用与法定BAC/BrAC不同的适当BAC/BrAC转换进行呼气酒精检测，可能是急诊科酒精中毒常规筛查和管理的可靠替代方法。
