Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia.
Department of Anaesthesia, Queensland Children's Hospital, South Brisbane, Qld, Australia.
Paediatr Anaesth. 2021 Aug;31(8):839-845. doi: 10.1111/pan.14208. Epub 2021 Jun 13.
Continuous capnography has been recognised as an essential monitoring device in all anesthetized patients, despite which airway device is in use, regardless of their location, as a measure to improve patient safety. Capnography is the non-invasive measurement of a sample of the exhaled carbon dioxide which has multiple clinical uses including as a method to confirm placement of a tracheal tube and/or to assess ventilation, perfusion and metabolism. Notably, capnography is used during routine paediatric anesthesia to assess ventilation and as a surrogate measure for arterial carbon dioxide pressure. The inaccuracies associated with these surrogate measures need to be considered to inform improved ventilation management of infants and children. This review highlights some major principles to understand the carbon dioxide elimination, the physiology of paediatric capnography, the clinical application and the limitations of capnography during anesthesia for neonates, infants and small children.
连续二氧化碳描记术已被认为是所有麻醉患者的基本监测设备，无论使用何种气道装置，无论其位置如何，均可作为提高患者安全性的措施。二氧化碳描记术是对呼出的二氧化碳样本进行无创测量，具有多种临床用途，包括作为确认气管导管位置和/或评估通气、灌注和代谢的方法。值得注意的是，二氧化碳描记术在儿科麻醉常规中用于评估通气，并作为动脉二氧化碳压力的替代测量指标。需要考虑这些替代测量指标的不准确性，以告知对婴儿和儿童的通气管理进行改进。这篇综述强调了一些主要原则，以了解二氧化碳的消除、儿科二氧化碳描记术的生理学、临床应用以及在新生儿、婴儿和幼儿麻醉期间二氧化碳描记术的局限性。
