Janssens J P, Howarth-Frey C, Chevrolet J C, Abajo B, Rochat T
Division of Pulmonary Medicine, University Hospital, Geneva, Switzerland.
Chest. 1998 Mar;113(3):768-73. doi: 10.1378/chest.113.3.768.
The present study was designed to analyze the usability of a commercially available, transcutaneous PCO2 (TcPCO2) sensor for monitoring noninvasive positive pressure ventilation (NPPV). Twenty-six hemodynamically stable patients with intra-arterial radial catheters were assessed. After stabilization of TcPCO2, arterial blood was analyzed and results were compared with TcPCO2 at time of sampling. To evaluate the drift of the signal, samples were taken hourly in five patients for 4 h while continuously recording TcPCO2. Finally, to assess for the response of the sensor to changes in PaCO2, six patients underwent continuous TcPCO2 recording while initiating or interrupting NPPV; arterial samples were analyzed before the event, and 1, 3, 5, 7, 9, and 20 min afterwards.
TcPCO2 and PaCO2 were tested over a range of 26 to 71 mm Hg, and were found to be closely correlated (r=0.968, p<0.0001); mean bias was 0.75 mm Hg. There was no significant drift of TcPCO2 as compared with PaCO2 over 4 h. The time of response of TcPCO2 to initiation or interruption of NPPV was <60 s. An estimation of the lag time averaged 5+/-3 min (range, 1 to 9 min).
TcPCO2 in hemodynamically stable adults was in excellent agreement with arterial measurements. The time of response to a change in ventilation was compatible with the aim of clinical monitoring of patients under NPPV.
本研究旨在分析一种市售的经皮二氧化碳分压（TcPCO2）传感器用于监测无创正压通气（NPPV）的可用性。对26例血流动力学稳定且有桡动脉内导管的患者进行了评估。在TcPCO2稳定后，分析动脉血并将结果与采样时的TcPCO2进行比较。为评估信号漂移，对5例患者每小时采样一次，持续4小时，同时连续记录TcPCO2。最后，为评估传感器对PaCO2变化的反应，6例患者在启动或中断NPPV时进行连续TcPCO2记录；在事件发生前、之后1、3、5、7、9和20分钟采集动脉样本进行分析。
在26至74毫米汞柱的范围内对TcPCO2和PaCO2进行了测试，发现两者密切相关（r = 0.968，p < 0.0001）；平均偏差为0.75毫米汞柱。与PaCO2相比，TcPCO2在4小时内无明显漂移。TcPCO2对NPPV启动或中断的反应时间<60秒。滞后时间估计平均为5±3分钟（范围为1至9分钟）。
血流动力学稳定的成年人的TcPCO2与动脉测量结果高度一致。对通气变化的反应时间符合NPPV患者临床监测的目的。
