Steurer J, Hoffmann U, Dür P, Russi E, Vetter W
Medical Policlinic, University Hospital, Zurich, Switzerland.
Respiration. 1997;64(3):200-5. doi: 10.1159/000196671.
The purposes of our study were (1) to investigate whether a 3-min short-term hyperventilation leads to posthyperventilatory hypoxemia and (2) to assess the role of transcutaneous blood gas measurements for monitoring oxygen and carbon dioxide changes during the after the test. In 10 male volunteers arterial and transcutaneous blood gases were measured simultaneously before, during and after a 3-min voluntary hyperventilation maneuver. Baseline arterial PO2 increased from 13.7 +/- 0.4 kPa (103 +/- 3 mm Hg) to 18.6 +/- 0.3 kPa (139 +/- 2.3 mm Hg; p < 0.005 compared to baseline) during hyperventilation. After the provocation test posthyperventilatory hypoxemia occurred with a minimal mean value of 7.8 +/- 1.3 kPa (58.5 +/- 9.8 mm Hg; p < 0.05 compared to baseline). Whereas close agreement between arterial and transcutaneous measurements was obtained for carbon dioxide values before hyperventilation, transcutaneous O2 consistently underestimated arterial O2. A short-term over-breathing of 3 min causes a significant posthyperventilatory hypoxemia. We hypothesize that posthyperventilatory hypoxemia is caused by hypopnea as a result of depleted CO2 body stores. Noninvasive transcutaneous blood gas measurements are not reliable for monitoring blood gas changes during and after hyperventilation, most probably because of the slow response time of the electrodes and the reflex vasoconstriction of the skin vessels.
(1)调查3分钟的短期过度通气是否会导致过度通气后低氧血症;(2)评估经皮血气测量在监测测试后氧气和二氧化碳变化中的作用。在10名男性志愿者中,在3分钟的自主过度通气操作前、操作期间和操作后同时测量动脉血气和经皮血气。过度通气期间,基线动脉血氧分压从13.7±0.4kPa(103±3mmHg)升至18.6±0.3kPa(139±2.3mmHg;与基线相比,p<0.005)。激发试验后出现过度通气后低氧血症,最低平均值为7.8±1.3kPa(58.5±9.8mmHg;与基线相比,p<0.05)。虽然过度通气前二氧化碳值的动脉测量和经皮测量结果非常一致,但经皮氧分压始终低于动脉氧分压。3分钟的短期过度呼吸会导致明显的过度通气后低氧血症。我们推测,过度通气后低氧血症是由于体内二氧化碳储备耗尽导致呼吸浅慢所致。无创经皮血气测量在监测过度通气期间和之后的血气变化方面不可靠,这很可能是由于电极响应时间缓慢以及皮肤血管反射性血管收缩所致。