Zetterström H
Department of Anaesthesia, Ostersund Hospital, Sweden.
Acta Anaesthesiol Scand. 1989 Apr;33(3):250-4. doi: 10.1111/j.1399-6576.1989.tb02900.x.
Determination of venous admixture (physiological shunt, Qva/Qt) requires analysis of both arterial and mixed venous blood. When a pulmonary arterial catheter is not in use, the pulmonary oxygenating capacity may be assessed from arterial blood gas data, the fraction of inspired oxygen (FIO2) and an assumed value of the arterial-mixed venous oxygen content difference. To facilitate this process, a slide-rule based on the "virtual shunt" concept is presented. It permits rapid assessment of Qva/Qt from known values of arterial oxygen tension (PaO2) or saturation (SaO2) and FIO2 and may promote the choice of appropriate FIO2. The limitations of the slide-rule were studied theoretically and its validity was tested by comparing 100 determinations of virtual shunt with the corresponding Qva/Qt values. The slide-rule was found to estimate Qva/Qt more accurately than commonly used oxygenation indices such as the PaO2/FIO2 ratio.
静脉血掺杂(生理性分流,Qva/Qt)的测定需要对动脉血和混合静脉血进行分析。当未使用肺动脉导管时,可根据动脉血气数据、吸入氧分数(FIO2)以及动脉 - 混合静脉血氧含量差的假定值来评估肺的氧合能力。为便于这一过程,本文介绍了一种基于“虚拟分流”概念的计算尺。它允许根据已知的动脉血氧分压(PaO2)或饱和度(SaO2)以及FIO2值快速评估Qva/Qt,并有助于选择合适的FIO2。从理论上研究了该计算尺的局限性,并通过将100次虚拟分流测定值与相应的Qva/Qt值进行比较来检验其有效性。结果发现,该计算尺比常用的氧合指数(如PaO2/FIO2比值)能更准确地估计Qva/Qt。