经皮氧和二氧化碳监测。在重症监护病房成年外科患者中的应用。

Transcutaneous oxygen and carbon dioxide monitoring. Use in adult surgical patients in an intensive care unit.

作者信息

Schachter E N, Rafferty T D, Knight C, Yocher R, Mentelos R, Giambalvo L, Firestone L, Barash P G

出版信息

Arch Surg. 1981 Sep;116(9):1193-6. doi: 10.1001/archsurg.1981.01380210063013.

DOI:10.1001/archsurg.1981.01380210063013

Abstract

We evaluated a combined transcutaneous oxygen and carbon dioxide (tcPO2 and tcPO2) monitor in 33 adult surgical patients in an intensive care unit. Surgical procedures included cardiothoracic, general, vascular, and orthopedic operations. Ninety-three paired, transcutaneous values were compared with simultaneously determined arterial blood gas measurements. The correlation coefficient for PaO2 was .75 (P less than .01) whereas for PaCO2 it was .55 (P less than .01). Although statistically significant, individual transcutaneous values differed by as much as 50 mm Hg from levels determined from arterial samples. Such differences make it inappropriate to use this monitor to predict actual PaO2 or PaCO2. By contrast, continuous monitoring allowed observation of acute changes associated with respiratory-care procedures and cardiovascular decompensation. Such acute changes changes were appreciated on the tcPO2 tracing but not the tcPO2 tracing. We conclude that the tcPO2 monitor is a valuable trend indicator of cardiopulmonary dysfunction, but that the tcPCO2 monitor is not.

摘要

我们在重症监护病房对33例成年外科手术患者使用了经皮氧和二氧化碳（tcPO2和tcPCO2）联合监测仪。手术类型包括心胸外科、普通外科、血管外科和骨科手术。将93对经皮测量值与同时测定的动脉血气测量值进行比较。PaO2的相关系数为0.75（P＜0.01），而PaCO2的相关系数为0.55（P＜0.01）。尽管在统计学上具有显著意义，但经皮测量的个体值与动脉样本测定值相差高达50 mmHg。这些差异使得使用该监测仪预测实际的PaO2或PaCO2并不合适。相比之下，连续监测能够观察到与呼吸护理程序和心血管失代偿相关的急性变化。此类急性变化在tcPO2曲线上可以观察到，但在tcPCO2曲线上则观察不到。我们得出结论，tcPO2监测仪是心肺功能障碍的一个有价值的趋势指标，但tcPCO2监测仪并非如此。