Abraham E, Gallagher T J, Fink S
Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver 80262, USA.
Intensive Care Med. 1996 May;22(5):507-13. doi: 10.1007/BF01712177.
To evaluate the in vivo performance of a continuous, intra-arterial, multiparameter blood-gas sensor containing a thermocouple, miniaturized polarographic oxygen electrode, as well as fiberoptic pH and pCO2 sensors.
Prospective, multicenter study comparing pH, PaCO2, and PaO2 measurements from the intraarterial sensor with those obtained from a conventional, laboratory blood-gas monitor.
Intensive care units in three academic medical centers.
Adult ICU patients (n = 26) with a clinical need for a radial artery catheter and frequent monitoring of arterial blood gases for > or = 3 days.
All patients had the multiparameter intra-arterial sensor placed through a 20-gauge catheter into the radial artery. Every 4 h, or more frequently if clinically indicated, a blood-gas sample was withdrawn from the radial artery catheter and sent to the laboratory for analysis using a conventional laboratory blood-gas analyzer. Immediately prior to withdrawal of the arterial blood, values for pH, PaCO2, and PaO2 from the multiparameter intra-arterial sensor were recorded.
The multiparameter sensor was placed into 26 patients. In 7 of the patients, premature discontinuation of monitoring was necessary because of dampening of the pressure tracing, difficulty in withdrawing blood from the arterial catheter, or bending of the extra-arterial fiberoptic channel owing to the cable being inadequately secured (mean monitoring time in these 7 patients: 40.6 +/- 25.7 h). In the other 19 patients, monitoring was continued until no longer clinically indicated. In these patients, a total of 341 data sets was collected, with the average length of monitoring being 69.9 +/- 37.9 h (range 22.0 to 57.9 h). Comparison of the sensor values with those from the blood-gas analyzer showed bias and precision values of 0.006 and 0.026 for arterial pH - 1.19% and 12.54% for PaO2, and 1.28 mmHg and 2.48 mmHg for PaCO2, respectively. No complications were associated with the intra-arterial sensor.
Clinical performance of this intra-arterial, multiparameter blood-gas sensor demonstrated stability, consistency, and accuracy comparable to laboratory blood-gas analyzers. The present multiparameter, intravascular blood-gas sensor, when inserted in the radial artery, can provide stable and accurate monitoring of pH, PaCO2, and PaO2 over clinically relevant periods of as long as 6 days in the critical care setting.
评估一种连续的、动脉内的多参数血气传感器的体内性能，该传感器包含一个热电偶、小型化极谱氧电极以及光纤pH和pCO₂传感器。
前瞻性多中心研究，比较动脉内传感器测得的pH、PaCO₂和PaO₂值与传统实验室血气监测仪测得的值。
三个学术医疗中心的重症监护病房。
有临床需求放置桡动脉导管且需要频繁监测动脉血气≥3天的成年ICU患者（n = 26）。
所有患者通过20号导管将多参数动脉内传感器置入桡动脉。每4小时，或根据临床指征更频繁地从桡动脉导管抽取血气样本，并送至实验室使用传统实验室血气分析仪进行分析。在抽取动脉血之前，记录多参数动脉内传感器测得的pH、PaCO₂和PaO₂值。
多参数传感器置入26例患者体内。7例患者因压力波形衰减、从动脉导管抽血困难或动脉外光纤通道因电缆固定不充分而弯曲，需要提前终止监测（这7例患者的平均监测时间：40.6±25.7小时）。其他19例患者持续监测直至不再有临床指征。在这些患者中，共收集了341组数据集，平均监测时长为69.9±37.9小时（范围22.0至57.9小时）。传感器值与血气分析仪值的比较显示，动脉pH的偏差和精密度值分别为0.006和0.026，PaO₂为 -1.19%和12.54%，PaCO₂为1.28 mmHg和2.48 mmHg。动脉内传感器未出现并发症。
这种动脉内多参数血气传感器的临床性能显示出与实验室血气分析仪相当的稳定性、一致性和准确性。当前的多参数血管内血气传感器插入桡动脉后，在重症监护环境中可在长达6天的临床相关时间段内稳定、准确地监测pH、PaCO₂和PaO₂。
