Kaisdotter Andersson Annika, Kron Josefine, Castren Maaret, Muntlin Athlin Asa, Hok Bertil, Wiklund Lars
Hök Instrument AB, Västerås, Sweden.
Karolinska Institutet, Department of Clinical Research and Education, Södersjukhuset, Stockholm, Sweden.
Scand J Trauma Resusc Emerg Med. 2015 Feb 6;23:11. doi: 10.1186/s13049-014-0082-y.
Many patients seeking emergency care are under the influence of alcohol, which in many cases implies a differential diagnostic problem. For this reason early objective alcohol screening is of importance not to falsely assign the medical condition to intake of alcohol and thus secure a correct medical assessment.
At two emergency departments, demonstrate the feasibility of accurate breath alcohol testing in emergency patients with different levels of cooperation.
Assessment of the correlation and ratio between the venous blood alcohol concentration (BAC) and the breath alcohol concentration (BrAC) measured in adult emergency care patients. The BrAC was measured with a breathalyzer prototype based on infrared spectroscopy, which uses the partial pressure of carbon dioxide (pCO₂) in the exhaled air as a quality indicator.
Eighty-eight patients enrolled (mean 45 years, 53 men, 35 women) performed 201 breath tests in total. For 51% of the patients intoxication from alcohol or tablets was considered to be the main reason for seeking medical care. Twenty-seven percent of the patients were found to have a BAC of <0.04 mg/g. With use of a common conversion factor of 2100:1 between BAC and BrAC an increased agreement with BAC was found when the level of pCO₂ was used to estimate the end-expiratory BrAC (underestimation of 6%, r = 0.94), as compared to the BrAC measured in the expired breath (underestimation of 26%, r = 0.94). Performance of a forced or a non-forced expiration was not found to have a significant effect (p = 0.09) on the bias between the BAC and the BrAC estimated with use of the level of CO₂. A variation corresponding to a BAC of 0.3 mg/g was found between two sequential breath tests, which is not considered to be of clinical significance.
With use of the expired pCO₂ as a quality marker the BrAC can be reliably assessed in emergency care patients regardless of their cooperation, and type and length of the expiration.
许多寻求急诊治疗的患者受到酒精影响，这在许多情况下意味着存在鉴别诊断问题。因此，早期进行客观的酒精筛查很重要，以免将病情错误归因于酒精摄入，从而确保正确的医疗评估。
在两个急诊科，证明在不同合作程度的急诊患者中进行准确呼气酒精检测的可行性。
评估成年急诊患者静脉血酒精浓度（BAC）与呼气酒精浓度（BrAC）之间的相关性和比率。使用基于红外光谱的呼气酒精检测仪原型测量BrAC，该仪器将呼出气体中的二氧化碳分压（pCO₂）用作质量指标。
88名患者入组（平均45岁，53名男性，35名女性），共进行了201次呼气测试。51%的患者因酒精或药物中毒被认为是寻求医疗护理的主要原因。27%的患者BAC<0.04mg/g。当使用BAC与BrAC之间常用的2100:1转换系数时，与在呼出气体中测量的BrAC相比（低估26%，r = 0.94），使用pCO₂水平估计呼气末BrAC时与BAC的一致性更高（低估6%，r = 0.94）。未发现强制呼气或非强制呼气对使用CO₂水平估计的BAC与BrAC之间的偏差有显著影响（p = 0.09）。在两次连续呼气测试之间发现了相当于0.3mg/g BAC的变化，这被认为不具有临床意义。
使用呼出的pCO₂作为质量标志物，无论急诊患者的合作程度、呼气类型和时长如何，均可可靠地评估BrAC。
