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[呼气末二氧化碳监测中EMMA的临床应用价值]

[Clinical usefulness of EMMA for monitoring end-tidal carbon dioxide].

作者信息

Kameyama Miki, Uehara Kenji, Takatori Makoto, Tada Keiichi

机构信息

Department of Anesthesia and Critical Care Medicine, Hiroshima City Hospital, Hiroshima 730-8518.

出版信息

Masui. 2013 Apr;62(4):477-80.

Abstract

BACKGROUND

Transportable capnometers(EMMA) can be useful in the emergency department or Rapid Response System. Before EMMA can be implemented, it must be compared with currently employed capnography methods. Methods : The concentration of CO2 in a reference gas was measured by two EMMA machines and a side-stream capnometer (CAPNOX ), respectively. Next, Etco2 in twelve patients under general anesthesia was measured by both EMMA machines and the side-stream capnometer, respectively. Results were analyzed using Pearson's correlation coefficient and the Bland-Altman plot. Results : With regard to the reference gas ([CO2] of 38 mmHg), the EMMA machines reported CO, concentrations of 37.2 mmHg and 35 mmHg, and the capnometer reported 38 mmHg. For the 12 anesthetized patients, 47 Etco2 readings were taken. Pearson's correlation coefficient between the first EMMA machine and the capnometer was 0.98 (P<0.0001, bias 3.6 mmHg, 95% limits of agreement 1.3-5.9mmHg) and between the second EMMA machine and the capnometer was 0.99 (P<0.0001, bias 0.85 mmHg, 95% limits of agreement-0.7-2.4 mmHg).

CONCLUSIONS

In patients under general anesthesia, EMMA measured Etco2 within 4 mmHg of side-stream capnography, indicating sufficient accuracy for clinical use. At the same time, discrepancies in readings between individual machines must be taken into consideration.

摘要

背景

便携式二氧化碳监测仪(EMMA)在急诊科或快速反应系统中可能会很有用。在实施EMMA之前,必须将其与当前使用的二氧化碳监测方法进行比较。方法:分别用两台EMMA仪器和一台旁流二氧化碳监测仪(CAPNOX)测量参考气体中的二氧化碳浓度。接下来,分别用两台EMMA仪器和旁流二氧化碳监测仪测量12例全身麻醉患者的呼气末二氧化碳分压(Etco2)。使用Pearson相关系数和Bland-Altman图分析结果。结果:对于参考气体(二氧化碳浓度为38 mmHg),EMMA仪器报告的二氧化碳浓度分别为37.2 mmHg和35 mmHg,而二氧化碳监测仪报告的为38 mmHg。对于12例麻醉患者,共获取了47个Etco2读数。第一台EMMA仪器与二氧化碳监测仪之间的Pearson相关系数为0.98(P<0.0001,偏差3.6 mmHg,95%一致性界限为1.3 - 5.9 mmHg),第二台EMMA仪器与二氧化碳监测仪之间的Pearson相关系数为0.99(P<0.0001,偏差0.85 mmHg,95%一致性界限为 - 0.7 - 2.4 mmHg)。

结论

在全身麻醉患者中,EMMA测量的Etco2与旁流二氧化碳监测法的测量结果相差在4 mmHg以内,表明其临床使用准确性足够。同时,必须考虑不同仪器读数之间的差异。

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