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出血复苏期间的心肺和结膜氧分压监测。

Cardiorespiratory and conjunctival oxygen tension monitoring during resuscitation from hemorrhage.

作者信息

Abraham E, Fink S

出版信息

Crit Care Med. 1986 Dec;14(12):1004-9. doi: 10.1097/00003246-198612000-00002.

Abstract

Placement of an unheated miniaturized oxygen electrode against the palpebral conjunctiva permits noninvasive measurement of tissue oxygen tension. In this study, the relationship between conjunctival oxygen tension (PcjO2) and standard cardiorespiratory variables was examined during a sequential resuscitation protocol after acute hemorrhage. Anesthetized dogs were rapidly bled to a mean arterial pressure of 40 mm Hg and then retransfused with the shed blood in a stepwise fashion. PcjO2 fell to 2% of control values after hemorrhage and did not return to prehemorrhage values until more than 90% of the shed blood had been reinfused. PcjO2 was among the last set of cardiorespiratory variables to return to control values during resuscitation and was the last noninvasive variable to normalize. The ratio of PcjO2 to arterial oxygen tension decreased from a prehemorrhage value of 0.76 +/- 0.05 (SEM) to 0.02 +/- 0.003 after hemorrhage, and did not increase to values greater than 0.50 until resuscitation was more than 90% complete. Conjunctival oxygen monitoring may play an important role in assessing the adequacy of resuscitation after acute hemorrhage.

摘要

将未加热的小型化氧电极置于睑结膜上可实现对组织氧张力的无创测量。在本研究中,在急性出血后的序贯复苏方案期间,检测结膜氧张力(PcjO2)与标准心肺变量之间的关系。将麻醉的犬迅速放血至平均动脉压为40 mmHg,然后逐步回输流出的血液。出血后PcjO2降至对照值的2%,直到回输超过90%的流出血液后才恢复到出血前的值。在复苏过程中,PcjO2是最后恢复到对照值的一组心肺变量之一,也是最后恢复正常的无创变量。PcjO2与动脉氧张力的比值从出血前的0.76±0.05(SEM)降至出血后的0.02±0.003,直到复苏完成超过90%时才升至大于0.50的值。结膜氧监测可能在评估急性出血后复苏的充分性方面发挥重要作用。

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