5%碳酸氢钠与10%氯化钠作为电阻抗断层成像肺灌注造影剂的比较：一项前瞻性临床研究。

Comparison of 5% sodium bicarbonate and 10% sodium chloride as contrast agents for lung perfusion with electrical impedance tomography: a prospective clinical study.

作者信息

Gao Yelin, He Yuecheng, Chi Yi, Yuan Siyi, Wu Songlin, Long Yun, Zhao Zhanqi, He Huaiwu

机构信息

State Key Laboratory of Complex Severe and Rare Diseases, Department of Critical Care Medicine, Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Intensive Care Unit, Wujin Hospital Affiliated with Jiangsu University, Jiangsu, China.

出版信息

BMC Pulm Med. 2025 Apr 23;25(1):190. doi: 10.1186/s12890-025-03665-2.

DOI:10.1186/s12890-025-03665-2

PMID:40269841

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12016440/

Abstract

INTRODUCTION

This study aimed to compare sodium bicarbonate (NaHCO) and sodium chloride (NaCl) as contrast agents for regional lung perfusion imaging with electrical impedance tomography in critically ill patients with respiratory failure.

METHODS

15 mL 5% NaHCO and 10 mL 10% NaCl were sequentially administered in all the enrolled patients with respiratory failure. EIT maps were divided into four cross-regions: upper right (UR), upper left (UL), lower right (LR), and lower left (LL).

RESULT

A total of 20 pair bolus injections from 16 mechanically ventilated patients were obtained. Compared to NaHCO, NaCl caused a larger drop of maximum impedance amplitude after the bolus injection (1276 ± 329 vs. 509 ± 159 AU, P < 0.001). Regional perfusion distribution (%) of four cross-regions between two indicators were significantly correlated (R = 0.90 for regional perfusion%, p < 0.001; R = 0.93 for regional ventilation/perfusion matching, p < 0.001) in 80 pair measurements. The Bland-Altman analysis showed a strong overall agreement in regional perfusion distribution (%) [mean bias 0.09% (95% confidence interval, CI: -0.91%, 1.09%), lower limits of agreement (LOA) -8.03% (95% CI: -9.75%, -6.31%), upper LOA 8.21% (95% CI: 6.48%, 9.93%)] between indicators in 80 pair measurements.

CONCLUSION

EIT with NaHCO as a contrast agent yields a high agreement of regional lung perfusion compared to NaCl in critically ill patients with respiratory failure.

摘要

引言

本研究旨在比较碳酸氢钠（NaHCO）和氯化钠（NaCl）作为对比剂，用于呼吸衰竭重症患者区域肺灌注成像电阻抗断层扫描的效果。

方法

对所有纳入研究的呼吸衰竭患者依次静脉注射15 mL 5% NaHCO和10 mL 10% NaCl。电阻抗断层扫描（EIT）图像被划分为四个交叉区域：右上（UR）、左上（UL）、右下（LR）和左下（LL）。

结果

共获取了16例机械通气患者的20对团注注射数据。与NaHCO相比，NaCl团注注射后最大阻抗幅度下降更大（1276±329与509±159 AU，P<0.001）。在80对测量中，两种指示剂之间四个交叉区域的区域灌注分布（%）显著相关（区域灌注%，R=0.90，p<0.001；区域通气/灌注匹配，R=0.93，p<0.001）。Bland-Altman分析显示，在80对测量中，两种指示剂之间区域灌注分布（%）总体一致性较强[平均偏差0.09%（95%置信区间，CI：-0.91%，1.09%），一致性下限（LOA）-8.03%（95% CI：-9.75%，-6.31%），一致性上限LOA 8.21%（95% CI：6.48%，9.93%）]。