Oropello J M, Manasia A, Hannon E, Leibowitz A, Benjamin E
Department of Surgery, Mount Sinai Medical Center, New York, USA.
Chest. 1996 Apr;109(4):1049-55. doi: 10.1378/chest.109.4.1049.
To compare the performance of continuous fiberoptic blood gas monitoring with standard, intermittent blood gas sampling in the measurement of arterial and central venous blood gases during marked hemodynamic changes.
Prospective, consecutive, enrollment, experimental study.
Research laboratory at a university medical center.
Seven anesthetized, mechanically ventilated pigs.
Severe shock was induced by hemorrhage in pigs monitored by a pulmonary artery catheter, an arterial line, and two fiberoptic blood gas sensors: one intra-arterial, and the other inserted into the superior vena cava via right internal jugular vein cutdown. Fiberoptic blood gas monitor measurements were compared with standard intermittent blood gas sampling.
A total of 184 blood gas samples were compared in seven animals at baseline, during shock, and after resuscitation. The baseline mean (+/- 1 SD) cardiac output decreased from 4.0 +/- 0.9 to 1.2 +/- 0.6 L/min during shock and returned to baseline after retransfusion (3.9 +/- 1.3 L/min). The comparison of continuous fiberoptic blood gas monitoring with intermittent blood gas sampling showed a bias+/-precision of 0.035 +/- 0.047 for arterial pH, 0.021 +/- 0.031 for central venous pH, -4.09 +/- 2.96 mm Hg (-0.55 +/- 0.39 kPa) for arterial Pco2, -3.67 +/- 2.44 mm Hg (-0.49 +/- 0.3 3 kPa) for central venous Pco2, -5.79 +/- 9.64 mm Hg (-0.77 +/- 1.29 kPa) for arterial Po2, and -7.85 +/- 8.52 mm Hg (-1.05 +/- 1.14 kPa) for central venous Po2.
Continuous fiberoptic blood gas monitoring agrees closely with standard intermittent blood gas sampling during severe hemodynamic shifts and has a comparable accuracy for both arterial and venous blood gas measurements. Changes in venous Pco2 have recently been shown to correlate with changes in global tissue perfusion (eg, changes in cardiac output). Such data, available immediately via continuous venous blood gas monitoring, may be useful for monitoring shock and the response to resuscitation.
比较在显著血流动力学变化期间，连续光纤血气监测与标准间歇性血气采样在测量动脉血和中心静脉血气方面的性能。
前瞻性、连续性、入组、实验性研究。
大学医学中心的研究实验室。
七只麻醉状态下接受机械通气的猪。
通过肺动脉导管、动脉管路以及两个光纤血气传感器对猪进行监测，通过放血诱导严重休克，其中一个光纤血气传感器置于动脉内，另一个通过右颈内静脉切开插入上腔静脉。将光纤血气监测仪的测量结果与标准间歇性血气采样结果进行比较。
在七只动物的基线期、休克期和复苏后，共比较了184份血气样本。基线时平均（±1标准差）心输出量在休克期间从4.0±0.9降至1.2±0.6升/分钟，输血后恢复至基线水平（3.9±1.3升/分钟）。连续光纤血气监测与间歇性血气采样的比较显示，动脉血pH的偏差±精密度为0.035±0.047，中心静脉血pH为0.021±0.031，动脉血Pco2为-4.09±2.96毫米汞柱（-0.55±0.39千帕），中心静脉血Pco2为-3.67±2.44毫米汞柱（-0.49±0.33千帕），动脉血Po2为-5.79±9.64毫米汞柱（-0.77±1.29千帕），中心静脉血Po2为-7.85±8.52毫米汞柱（-1.05±1.14千帕）。
在严重血流动力学变化期间，连续光纤血气监测与标准间歇性血气采样结果高度一致，在动脉血和静脉血气测量方面具有相当的准确性。最近研究表明，静脉血Pco2的变化与整体组织灌注的变化（如心输出量的变化）相关。通过连续静脉血气监测可立即获得此类数据，可能有助于监测休克及复苏反应。
