急诊科应用二氧化碳测量对肺栓塞相关休克进行早期鉴别诊断：病例系列研究
CO2 measurement for the early differential diagnosis of pulmonary embolism-related shock at the emergency department: A case series.
作者信息
Van Marcke Cédric, Daoudia Anas, Penaloza Andrea, Verschuren Franck
机构信息
Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Emergency Department, Brussels, Belgium.
出版信息
Respir Med Case Rep. 2015 Sep 11;16:106-8. doi: 10.1016/j.rmcr.2015.09.004. eCollection 2015.
OBJECTIVE
An early differential diagnosis is mandatory when facing a patient with clinical shock of unclear aetiology, in order to guide proper treatment. We assessed if the expired CO2 measurement and alveolar-arterial CO2 calculation could improve the differential diagnosis of shock during its initial presentation, particularly in separating pulmonary embolism from other causes of shock.
METHODS
We analysed the charts of 12 patients who presented with clinical shock and had end-tidal CO2 (EtCO2) and arterial CO2 partial pressure (PaCO2) measurements.
RESULTS
In cases with pulmonary embolism-related shock (n = 3), the gradient between PaCO2 and EtCO2 was increased (37 vs 0.2 mmHg). There was a similar trend for a higher PaCO2 value (60 vs 32.2 mmHg) and a lower EtCO2 value (23 vs 32 mmHg).
CONCLUSION
An initial CO2 measurement might be an easily available tool for the early diagnostic work-up of clinical shock.
目的
面对病因不明的临床休克患者时，早期进行鉴别诊断以指导恰当治疗是必不可少的。我们评估了呼出二氧化碳测量和肺泡-动脉二氧化碳计算是否能在休克初始表现时改善其鉴别诊断，特别是在将肺栓塞与其他休克原因区分开来方面。
方法
我们分析了12例出现临床休克且进行了呼气末二氧化碳（EtCO2）和动脉二氧化碳分压（PaCO2）测量的患者的病历。
结果
在与肺栓塞相关的休克病例（n = 3）中，PaCO2与EtCO2之间的梯度增加（37对0.2 mmHg）。PaCO2值较高（60对32.2 mmHg）和EtCO2值较低（23对32 mmHg）也有类似趋势。
结论
初始二氧化碳测量可能是临床休克早期诊断检查中一种易于获得的工具。
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