Lanigan C, Ponte J, Moxham J
Department of Thoracic Medicine, King's College Hospital, London, U.K.
Adv Exp Med Biol. 1987;220:41-4. doi: 10.1007/978-1-4613-1927-6_6.
TcPO2 and tcPCO2 monitoring is widely used but the in vitro drift of the new combined sensors is unknown. We tested the in vivo stability of 3 such electrodes in six adults, compared to nasal endtidal values from a mass spectrometer. Each electrode was remembraned within 5 days and had a 2 point dry gas calibration at 45 degrees C before fixing to the subjects' right arms. TcPO2, tcPCO2 and endtidal values were averaged over four minutes after 30 minutes equilibration, and then at seven subsequent 20 minute intervals. We observed that (1) Endtidal values remained stable (2) tcPCO2 differed from baseline by less than 3 torr (3) tcPO2 rose significantly in all three electrodes by an average of 16 to 21% and, (4) in vivo drift greatly exceeded separately determined in vitro changes. We discuss the possible explanations for the observed results, and conclude that skin permeability changes may play an important role. In the light of the large in vivo tcPO2 drift, transcutaneous dual electrodes are not reliable trend indicators of blood gases in adults.
经皮氧分压(TcPO2)和经皮二氧化碳分压(tcPCO2)监测应用广泛,但新型组合传感器的体外漂移情况尚不清楚。我们在六名成年人中测试了3个此类电极的体内稳定性,并与质谱仪测得的鼻腔潮气末值进行了比较。每个电极在5天内重新覆膜,并在固定于受试者右臂之前于45摄氏度进行两点干气校准。在平衡30分钟后,对TcPO2、tcPCO2和潮气末值进行4分钟的平均,然后在随后的七个20分钟间隔进行测量。我们观察到:(1)潮气末值保持稳定;(2)tcPCO2与基线的差异小于3托;(3)所有三个电极的tcPO2均显著上升,平均上升16%至21%;(4)体内漂移大大超过单独测定的体外变化。我们讨论了观察结果的可能解释,并得出结论,皮肤通透性变化可能起重要作用。鉴于体内tcPO2的大幅漂移,经皮双电极并非成人体血气的可靠趋势指标。