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经皮二氧化碳分压测量作为失血性休克严重程度的指标。

Transcutaneous CO tension measurement as an indicator of severity of hemorrhagic shock.

作者信息

Yoshioka Masami

机构信息

The Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, 602, Kyoto, Japan.

出版信息

J Anesth. 1996 Dec;10(4):264-268. doi: 10.1007/BF02483393.

Abstract

This study was undertaken to evaluate whether transcutaneous CO tension (PtcCO) could be used as an indicator of the global systemic severity of hemorrhagic shock. PtcCO levels in ten anesthetized mongrel dogs were measured during hemorrhage and during volume restoration and were correlated with mixed venous CO tension ([Formula: see text]). After withdrawal of 30ml·kg blood, both PtcCO and[Formula: see text] increased significantly (from 43±7 to 70±27 torr (P<0.05) and from 48±6 to 59±12 torr (P<0.05), respectively). Throughout the experiments, PtcCO levels changed almost in parallel to[Formula: see text] levels. However, changes in PtcCO exceeded those in[Formula: see text] from the end of hemorrhage, at which time cardiac output decreased to 35% of the baseline value, until the end of volume restoration, and the changes in PtcCO showed a close logarithmic relationship with[Formula: see text] (r=0.78,n=110). Additionally, arterio-transcutaneous CO tension gradients[Formula: see text] showed a close exponential correlation with cardiac output per body weight (CO/BW) during the shedding phase (r=0.85,n=60), although the correlation with CO/BW lessened during the retransfusion phase (r=0.55,n=60). PtcCO was roughly correlated with[Formula: see text] during hemorrhagic shock, and levels of PtcCO higher than[Formula: see text] reflected critical tissue perfusion.

摘要

本研究旨在评估经皮二氧化碳分压(PtcCO)是否可作为失血性休克整体全身严重程度的指标。在出血期间和容量复苏期间,测量了10只麻醉杂种犬的PtcCO水平,并将其与混合静脉二氧化碳分压([公式:见正文])进行关联。抽取30ml·kg血液后,PtcCO和[公式:见正文]均显著升高(分别从43±7升至70±27托(P<0.05)和从48±6升至59±12托(P<0.05))。在整个实验过程中,PtcCO水平的变化几乎与[公式:见正文]水平平行。然而,从出血结束时起,PtcCO的变化超过了[公式:见正文]的变化,此时心输出量降至基线值的35%,直至容量复苏结束,且PtcCO的变化与[公式:见正文]呈密切的对数关系(r=0.78,n=110)。此外,在放血阶段,动脉-经皮二氧化碳分压梯度[公式:见正文]与每体重心输出量(CO/BW)呈密切的指数相关性(r=0.85,n=60),尽管在再输血阶段与CO/BW的相关性减弱(r=0.55,n=60)。在失血性休克期间,PtcCO与[公式:见正文]大致相关,且高于[公式:见正文]的PtcCO水平反映了关键组织灌注情况。

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