Goeckenjan G, Lenz W
Klin Wochenschr. 1979 Nov 15;57(22):1217-23. doi: 10.1007/BF01489249.
Continuous blood gas measurement by means of indwelling intraarterial electrodes facilitates and contributes to considerably improve the monitoring of pulmonary gas exchange in intensive care and anaesthesiology. Knowledge of the behaviour of the electrode surface in the blood stream is necessary to assess the characteristics of the measuring and the possible risks or complications. Scanning electron microscopic examinations were performed in a commercial-type polarographic PO2 electrode after in vitro and in vivo application. 14 electrodes were examined after continuous intra-arterial measurements in patients with chronic obstructive pulmonary disease and in intensive care patients. Duration of intra-arterial measurements was 2-109 h. Already after a measuring period of 2 h in nearly all cases a protein film was discovered on the electrode surface. Microthrombotic deposits were seen in 2 cases, in one of these despite of treatment with heparin. The electrode membrane showed a network ofmicro-cracks, small bubbles and dents. The membrane changes were probably the result of the drying process during the electron microscopic preparation, because the membrane material (Hydron) is hydrophil and swells during the measurement. Yet it cannot be excluded that these changes occur, in part, during the measurements. From these and other studies we conclude that the intra-arterial application of this electrode has a low risk of thromboembolic complications. The deposits on the electrode surface and the membrane changes may probably affect the response time and possibly also the stability of the electrode.
通过留置动脉内电极进行连续血气测量有助于并极大地促进了重症监护和麻醉中肺气体交换监测的改善。了解电极表面在血流中的行为对于评估测量特性以及可能的风险或并发症是必要的。在体外和体内应用后,对一种商用型极谱PO2电极进行了扫描电子显微镜检查。在慢性阻塞性肺疾病患者和重症监护患者中进行连续动脉内测量后,对14个电极进行了检查。动脉内测量持续时间为2至109小时。几乎在所有情况下,在测量2小时后,电极表面就发现了一层蛋白质膜。在2例中观察到微血栓沉积,其中1例尽管使用了肝素治疗。电极膜显示出微裂纹、小气泡和凹痕的网络。膜的变化可能是电子显微镜制备过程中干燥过程的结果,因为膜材料(Hydron)是亲水的,在测量过程中会膨胀。然而,不能排除这些变化部分发生在测量期间。从这些研究和其他研究中我们得出结论,该电极的动脉内应用血栓栓塞并发症风险较低。电极表面的沉积物和膜的变化可能会影响响应时间,也可能影响电极的稳定性。