Dean J M, Wetzel R C, Rogers M C
Crit Care Med. 1985 Dec;13(12):1029-33. doi: 10.1097/00003246-198512000-00009.
Oxygen transport data, prospectively collected from 52 critically ill children, were analyzed to determine whether any derived variable accurately estimated intrapulmonary shunt (Qsp/Qt). Arterial hemoglobin saturation was more closely correlated with Qsp/Qt than was PaO2, alveolar-arterial oxygen gradient, arterial mixed venous oxygen difference (C[a-v]O2), arterial/alveolar oxygen ratio, and the ratio of PaO2 to inspired oxygen (FIO2) (r = 0.8, p less than .0001). When C(a-v)O2 was normal, hemoglobin saturation became a very accurate (r = 0.96) assessment of Qsp/Qt. We conclude that various arterial blood gas derived variables do not accurately reflect Qsp/Qt in critically ill children. In these patients, a pulmonary artery catheter is needed to accurately assess intrapulmonary shunt.
对前瞻性收集的52名危重症儿童的氧输送数据进行分析，以确定是否有任何派生变量能准确估计肺内分流（Qsp/Qt）。与动脉血氧分压（PaO2）、肺泡-动脉血氧梯度、动脉-混合静脉血氧差（C[a-v]O2）、动脉/肺泡氧比值以及PaO2与吸入氧（FIO2）的比值相比，动脉血红蛋白饱和度与Qsp/Qt的相关性更强（r = 0.8，p < 0.0001）。当C(a-v)O2正常时，血红蛋白饱和度成为对Qsp/Qt非常准确的评估指标（r = 0.96）。我们得出结论，各种动脉血气派生变量不能准确反映危重症儿童的Qsp/Qt。对于这些患者，需要肺动脉导管来准确评估肺内分流。
