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[用于通气和气体交换分析与优化的容积式二氧化碳描记法]

[Volumetric capnography for analysis and optimization of ventilation and gas exchange].

作者信息

Böhm S H, Kremeier P, Tusman G, Reuter D A, Pulletz S

机构信息

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Rostock, Schillingallee 35, 18057, Rostock, Deutschland.

Simulationszentrum für klinische Beatmung Karlsruhe, Karlsruhe, Deutschland.

出版信息

Anaesthesist. 2020 May;69(5):361-370. doi: 10.1007/s00101-020-00747-0.

Abstract

Capnography as the graphical representation of the expiratory carbon dioxide (CO) concentration, is an essential component of monitoring of every ventilated patient, in addition to pulse oximetry. Capnography demonstrates the kinetics of CO in a noninvasive way and in real time. In the daily routine anesthesia, it mainly serves for identification of the correct intubation and adaptation of the respiratory minute volume to be applied; however, capnography can also provide much more far-reaching and clinically particularly valuable information, especially in the form of volumetric capnography (V) that is not yet so widely clinically available. These include monitoring and optimization of ventilation and assessment of gas exchange. This article presents parameters for making decisions at the bedside, which could previously only be obtained by extensive, more invasive, nonautomated procedures.

摘要

二氧化碳描记法作为呼气二氧化碳(CO)浓度的图形表示,除脉搏血氧饱和度测定外,是监测每例机械通气患者的重要组成部分。二氧化碳描记法以无创方式实时显示CO的动力学。在日常麻醉中,它主要用于确认正确插管以及调整应用的分钟通气量;然而,二氧化碳描记法还能提供更广泛且临床上特别有价值的信息,尤其是以尚未在临床上广泛应用的容积性二氧化碳描记法(V)的形式。这些信息包括通气的监测与优化以及气体交换评估。本文介绍了一些可在床边进行决策的参数,这些参数以前只能通过广泛、侵入性更强且非自动化的程序获得。

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