Nickerson B G, Patterson C, McCrea R, Monaco F
Pediatr Pulmonol. 1986 May-Jun;2(3):135-40. doi: 10.1002/ppul.1950020304.
The continuous, noninvasive estimation of arterial carbon dioxide tension (PaCO2) by heated skin surface electrodes has recently become available for pediatric patients. Skin surface (PsCO2) electrodes can enhance the safety of procedures such as intubation, bronchoscopy, ventilator changes, sleep studies, or measurement of the ventilatory response to CO2 or hypoxia. However, clinical situations that include rapid changes in PaCO2 demand knowledge of the in vivo response time. We compared the response of a heated PsCO2 electrode to end tidal CO2 (PetCO2) during abrupt changes in inspired CO2 from room air to 7% CO2 and back to room air. We obtained 54 curves on nine healthy subjects. There was an initial lag time with less than a 10% change in PsCO2. Then PsCO2 approached PetCO2 exponentially. For subjects at rest changing from breathing room air to 7% CO2, the initial lag time was 40 +/- 2 seconds and the 50% response time of the exponential portion was 46 +/- 3 seconds. Thus, it took 86 seconds for the electrode to record a 60% response to an abrupt increase in inspired CO2. The initial lag and 50% response time were considerably shorter during exercise (30 +/- 2 and 33 +/- 2 seconds) and even shorter when switched from breathing 7% CO2 to room air (23 +/- 2 and 21 +/- 2 seconds). Exercise did not further reduce the response time when CO2 was initially elevated, suggesting the faster response time was due to vasodilation of the skin due to elevated CO2.(ABSTRACT TRUNCATED AT 250 WORDS)
最近,通过加热皮肤表面电极对小儿患者进行动脉二氧化碳分压(PaCO2)的连续、无创估计已成为可能。皮肤表面(PsCO2)电极可提高诸如插管、支气管镜检查、呼吸机更换、睡眠研究或对CO2或低氧通气反应测量等操作的安全性。然而,包括PaCO2快速变化的临床情况需要了解体内反应时间。我们比较了在吸入CO2从室内空气突然变为7% CO2然后再变回室内空气的过程中,加热的PsCO2电极对呼气末CO2(PetCO2)的反应。我们在9名健康受试者身上获得了54条曲线。PsCO2最初有一个滞后时间,变化小于10%。然后PsCO2呈指数方式接近PetCO2。对于静息状态下从呼吸室内空气变为呼吸7% CO2的受试者,初始滞后时间为40±2秒,指数部分的50%反应时间为46±3秒。因此,电极记录到对吸入CO2突然增加的60%反应需要86秒。运动期间初始滞后和50%反应时间明显更短(分别为30±2秒和33±2秒),从呼吸7% CO2切换到呼吸室内空气时甚至更短(分别为23±2秒和21±2秒)。当CO2最初升高时运动并未进一步缩短反应时间,这表明更快的反应时间是由于CO2升高导致皮肤血管舒张。(摘要截选至250字)