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犬类和人类动脉内血气系统的初步评估。

Preliminary evaluation of an intra-arterial blood gas system in dogs and humans.

作者信息

Shapiro B A, Cane R D, Chomka C M, Bandala L E, Peruzzi W T

机构信息

Department of Anesthesia, Northwestern University Medical School, Chicago, IL 60611.

出版信息

Crit Care Med. 1989 May;17(5):455-60. doi: 10.1097/00003246-198905000-00016.

Abstract

The reliability and accuracy of an intra-arterial fluorescent optode system to measure continuously pHa, PaCO2, and PaO2 were evaluated in a dog model and in a group of critically ill patients. Six hundred sixty-three arterial blood gas (ABG) samples were analyzed for pHa, PaCO2, and PaO2 in the dog studies. The intra-arterial blood gas system (IBGS) indicated a steady state in 420 instances for pH, 359 instances for PaCO2, and 256 instances for PaO2. Comparison of these ABG and IBGS values by linear regression analysis revealed r = .97 for pHa, .95 for PaCO2, and .96 for PaO2. The mean +/- SD of the difference between ABG and IBGS was -0.02 +/- 0.03 for pHa, 1.05 +/- 3.8 for PaCO2, and -17 +/- 13 for PaO2. Nonsteady states were correctly identified by the IBGS in every instance. Comparisons between 79 temporally matched ABG and IBGS values, exclusive of in vivo calibration samples, in 12 critically ill patients revealed r = .97 for pHa, .96 for PaCO2, and .99 for PaO2. The difference was 0.002 +/- 0.02 for pHa, 0.44 +/- 2.97 for PaCO2, and -1.22 +/- 9.34 for PaO2. We conclude that it is possible to measure continuously pHa, PaCO2, and PaO2 with the IBGS in critically ill patients for periods from 3 to 25.5 h while maintaining the ability to monitor BP and withdraw blood samples from the arterial cannula. Agreement between the two techniques is within clinically acceptable ranges for pHa and PaCO2, whereas PaO2 measurement by the IBGS requires further refinement.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在犬模型和一组危重症患者中评估了一种用于连续测量动脉血酸碱度(pHa)、动脉血二氧化碳分压(PaCO2)和动脉血氧分压(PaO2)的动脉内荧光光极系统的可靠性和准确性。在犬类研究中,对663份动脉血气(ABG)样本进行了pHa、PaCO2和PaO2分析。动脉内血气系统(IBGS)显示pH值在420例中处于稳定状态,PaCO2在359例中处于稳定状态,PaO2在256例中处于稳定状态。通过线性回归分析比较这些ABG和IBGS值,结果显示pHa的r值为0.97,PaCO2的r值为0.95,PaO2的r值为0.96。ABG和IBGS之间差异的均值±标准差,pHa为-0.02±0.03,PaCO2为1.05±3.8,PaO2为-17±13。IBGS在每种情况下都能正确识别非稳定状态。对12例危重症患者中79对时间匹配的ABG和IBGS值(不包括体内校准样本)进行比较,结果显示pHa的r值为0.97,PaCO2的r值为0.96,PaO2的r值为0.99。pHa的差异为0.002±0.02,PaCO2的差异为0.44±2.97,PaO2的差异为-1.22±9.34。我们得出结论,在危重症患者中,使用IBGS能够连续3至25.5小时测量pHa、PaCO2和PaO2,同时保持监测血压和从动脉插管采集血样的能力。两种技术之间的一致性在pHa和PaCO2的临床可接受范围内,而IBGS测量PaO2需要进一步改进。(摘要截断于250字)

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