Hand I L, Shepard E K, Krauss A N, Auld P A
Department of Pediatrics, Cornell University Medical College, New York, NY 10021.
Crit Care Med. 1989 Jun;17(6):556-9. doi: 10.1097/00003246-198906000-00015.
PaCO2, transcutaneous PCO2 (PtcCO2), and end-tidal PCO2 (PetCO2) measurements were studied in 12 critically ill neonates. PtcCO2 was measured using a combination CO2/O2 sensor during the routine care of these patients. End-tidal sidestream sampling was performed during blood gas measurement as dictated by the patient's clinical condition. There was a linear correlation between PtcCO2 and PaCO2 (n = 51, r = .71, slope = 0.90). PetCO2 and PaCO2 did not correlate as well (n = 51, r = .52, slope = 0.42). Acidosis negatively affected the correlation between PtcCO2 and PaCO2. When pH was greater than 7.30, r = .75 and slope = 1.28 (n = 38), whereas when pH was less than 7.30, r = .62 and slope = 0.73 (n = 13). The presence or absence of a metabolic acidosis did not have a significant effect on the slopes obtained. PtcCO2 monitoring using combined sensors is a useful and practical means of monitoring in the neonatal ICU, although acidosis affects the ability to correlate transcutaneous and arterial values. End-tidal sidestream measurements are not as clinically useful because they vary due to different ventilation/perfusion relationships in the sick neonate.
对12例危重新生儿进行了动脉血二氧化碳分压（PaCO₂）、经皮二氧化碳分压（PtcCO₂）和呼气末二氧化碳分压（PetCO₂）的测量研究。在这些患儿的常规护理期间，使用二氧化碳/氧气组合传感器测量PtcCO₂。根据患儿的临床情况，在进行血气测量时进行呼气末旁流采样。PtcCO₂与PaCO₂之间存在线性相关性（n = 51，r = 0.71，斜率 = 0.90）。PetCO₂与PaCO₂的相关性则没那么好（n = 51，r = 0.52，斜率 = 0.42）。酸中毒对PtcCO₂与PaCO₂之间的相关性产生负面影响。当pH大于7.30时，r = 0.75，斜率 = 1.28（n = 38）；而当pH小于7.30时，r = 0.62，斜率 = 0.73（n = 13）。代谢性酸中毒的存在与否对所得斜率没有显著影响。使用组合传感器监测PtcCO₂是新生儿重症监护病房中一种有用且实用的监测手段，尽管酸中毒会影响经皮和动脉值之间的相关性。呼气末旁流测量在临床上没那么有用，因为在患病新生儿中，由于不同的通气/灌注关系，其值会有所变化。
