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血气分析的临床应用:危重症护理中动脉和静脉血气监测的比较综述

Clinical applications of blood gas analysis: a comparative review of arterial and venous blood gas monitoring in critical care.

作者信息

Lee Gyeo Ra

机构信息

Division of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Acute Crit Care. 2025 May;40(2):153-159. doi: 10.4266/acc.000900. Epub 2025 May 30.

Abstract

Blood gas analysis is an essential diagnostic tool used for assessing acid-base balance, ventilation, and oxygenation in critically ill patients. Arterial blood gas analysis (ABGA) remains the gold standard, primarily due to its accuracy in measuring oxygenation. Venous blood gas analysis (VBGA), in contrast, serves as a less invasive alternative and is particularly useful for evaluating acid-base status and metabolic function. Important parameters such as oxygen saturation of central venous blood (ScvO₂) and venous-to-arterial carbon dioxide pressure difference (∆pv-aCO₂) provide critical insights into hemodynamic status, cardiac output, and tissue perfusion. Although VBGA cannot replace ABGA for the precise assessment of oxygenation, it remains a valuable tool in clinical scenarios involving hemodynamic monitoring, shock management, and critical care decision-making.

摘要

血气分析是用于评估危重症患者酸碱平衡、通气和氧合的重要诊断工具。动脉血气分析(ABGA)仍然是金标准,主要是因为其在测量氧合方面的准确性。相比之下,静脉血气分析(VBGA)是一种侵入性较小的替代方法,对于评估酸碱状态和代谢功能特别有用。诸如中心静脉血氧饱和度(ScvO₂)和静脉-动脉二氧化碳压差(∆pv-aCO₂)等重要参数为血流动力学状态、心输出量和组织灌注提供了关键见解。虽然VBGA不能替代ABGA进行精确的氧合评估,但在涉及血流动力学监测、休克管理和重症监护决策的临床场景中,它仍然是一种有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42f5/12151744/293b74c581f5/acc-000900f1.jpg

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