Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Köln gGmbH, and Witten/Herdecke University Hospital, Cologne, Germany.
Ann Am Thorac Soc. 2014 May;11(4):645-52. doi: 10.1513/AnnalsATS.201311-387FR.
The relationship between an elevated partial pressure of carbon dioxide (Pco2) and reduced alveolar ventilation resulting from respiratory failure primarily affecting the respiratory pump was first reported during the 1952 Copenhagen polio epidemic. Several methods for Pco2 estimation, such as blood gas analyses, capnography, and transcutaneous Pco2 measurements, have since been developed to assess alveolar ventilation. The clinical setting in which CO2 measurement is valuable includes acute and chronic respiratory failure, transport, cardiopulmonary resuscitation, patient-controlled analgesia, and procedural sedation. The techniques that are currently available differ considerably regarding their accuracy, capacity to facilitate continuous assessment, side effects, availability, and their ability to assess additional information. Importantly, each technique has its own spectrum of indications and applications. Therefore, the different techniques are not competitive but, rather, complementary. As a consequence, it is reasonable to combine different techniques depending on specific clinical scenarios. This review summarizes the physiological background, historical development, instrument-specific technical aspects, and current recommendations for the clinical application of Pco2 assessment.
在 1952 年哥本哈根脊髓灰质炎流行期间，首次报道了因呼吸泵衰竭导致的二氧化碳分压（Pco2）升高和肺泡通气减少之间的关系，这种呼吸泵衰竭主要影响呼吸泵。此后，已经开发出几种 Pco2 估计方法，例如血气分析、二氧化碳描记术和经皮 Pco2 测量，以评估肺泡通气。CO2 测量有价值的临床环境包括急性和慢性呼吸衰竭、转运、心肺复苏、患者自控镇痛和程序镇静。目前可用的技术在准确性、连续评估能力、副作用、可用性以及评估其他信息的能力方面存在很大差异。重要的是，每种技术都有其自身的适应证和应用范围。因此，不同的技术不是竞争性的，而是互补性的。因此，根据特定的临床情况，合理地结合使用不同的技术。这篇综述总结了 Pco2 评估的生理背景、历史发展、仪器特定的技术方面以及目前的临床应用建议。
