呼气末二氧化碳监测对急诊科急性胃肠炎严重程度的预测价值。

Predictive value of capnography for severity of acute gastroenteritis in the emergency department.

机构信息

Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey.

出版信息

Am J Emerg Med. 2020 Jun;38(6):1159-1162. doi: 10.1016/j.ajem.2019.158404. Epub 2019 Aug 20.

DOI:10.1016/j.ajem.2019.158404

PMID:31462389

Abstract

OBJECTIVE

This study first aims to assess the utility of ETCO2 levels in evaluating the severity of dehydration in adult patients that present to the ED with acute gastroenteritis. AGE. Second, it intends to evaluate the correlation between ETCO2 and several metabolic parameters: creatinine, pH, bicarbonate (HCO3), and bases excessive (BE).

METHOD

This prospective study was conducted with AGE patients in the ED of a training and research hospital between June 2018 and April 2019 after approval of the local ethical-committee. The two groups were defined according to the severity of AGE: mild and non-mild groups. For both groups, ETCO2 levels were measured and recorded on admission of the patients.

RESULTS

87 patients were included in the analyses. The median of ETCO2 values was found as lower in non-mild group than mild group; 30 (25-35) & 39 (33-34), respectively (p < 0.001). In ROC analysis for distinguishing between the both groups, the AUC value was found to be 0.988 and the best cut-off level was found as 33.5 with 95% sensitivity and 93% specificity. In addition, strong negative correlation between ETCO2 and creatinine (p < 0.001, r: -0.771) were found.

CONCLUSION

ETCO2 levels decreased in the non-mild group of AGE patients; it could be useful to distinguish the mild group from the non-mild group. ETCO2 could be a reliable marker in predicting AKI in the management of AGE patients.

摘要

目的

本研究旨在评估 ETCO2 水平在评估因急性胃肠炎就诊于急诊科的成年患者脱水严重程度方面的效用。其次，评估 ETCO2 与肌酐、pH 值、碳酸氢盐（HCO3）和碱剩余（BE）等代谢参数之间的相关性。

方法

这是一项前瞻性研究，纳入了 2018 年 6 月至 2019 年 4 月期间在一家培训和研究医院急诊科就诊的 AGE 患者，研究获得了当地伦理委员会的批准。根据 AGE 的严重程度将患者分为两组：轻度和非轻度组。对于两组患者，均在入院时测量并记录 ETCO2 水平。

结果

共纳入 87 例患者进行分析。非轻度组的 ETCO2 值中位数明显低于轻度组，分别为 30（25-35）和 39（33-34）（p < 0.001）。在区分两组患者的 ROC 分析中，AUC 值为 0.988，最佳截断值为 33.5，具有 95%的敏感性和 93%的特异性。此外，还发现 ETCO2 与肌酐之间存在强烈的负相关（p < 0.001，r：-0.771）。