国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2015年
5期
358-360
,共3页
颅脑外伤%机械通气%呼气末二氧化碳分压
顱腦外傷%機械通氣%呼氣末二氧化碳分壓
로뇌외상%궤계통기%호기말이양화탄분압
Traumatic brain injury%Mechanical ventilation%Partial pressure of end tidal carbon dioxide
目的 研究颅脑外伤术后应用机械通气患者呼气末二氧化碳分压(partial pressure of end tidal carbon dioxide,PetCO2)与PaCO2相关性及肺泡动脉血二氧化碳分压差(alveolar-arterial carbon dioxide tension difference,a-ADCO2)变化规律,探讨PetCO2在颅脑外伤术后临床应用价值.方法 入选2012年6月至2014年6月入住ICU一科50例颅脑外伤术后应用机械通气患者,分别于设定潮气量6 ml/kg、8 ml/kg、10 ml/kg、12 ml/kg通气1h、6h、12h、24 h后抽取动脉血行血气分析并记录即刻PetCO2,同时计算a-ADCO2.结果 50例患者不同潮气量通气以及机械通气后1h、6h、12 h后PetCO2与PaCO2间相关性差异有统计学意义(P＜0.05),除12 ml/kg通气24 h外,a-ADCO2在其余潮气量不同时间段均小于5 mmHg,在8 ml/kg时为最低,通气1h、6h、12 h、24 h分别为(2.98±0.33)mmHg、(3.28±0.36) mmHg、(3.74±0.28) mmHg、(3.65±0.31) mmHg.结论 PetCO2与PaCO2具有一定的相关性,PetCO2可作为颅脑外伤术后患者机械通气早期评估PaCO2的手段之一.a-ADCO2在潮气量为8 ml/kg时最低,可作为呼吸机设置的起始参数之一.PetCO2是颅脑外伤术后患者行机械通气治疗时无创、连续的有效监测手段.
目的 研究顱腦外傷術後應用機械通氣患者呼氣末二氧化碳分壓(partial pressure of end tidal carbon dioxide,PetCO2)與PaCO2相關性及肺泡動脈血二氧化碳分壓差(alveolar-arterial carbon dioxide tension difference,a-ADCO2)變化規律,探討PetCO2在顱腦外傷術後臨床應用價值.方法 入選2012年6月至2014年6月入住ICU一科50例顱腦外傷術後應用機械通氣患者,分彆于設定潮氣量6 ml/kg、8 ml/kg、10 ml/kg、12 ml/kg通氣1h、6h、12h、24 h後抽取動脈血行血氣分析併記錄即刻PetCO2,同時計算a-ADCO2.結果 50例患者不同潮氣量通氣以及機械通氣後1h、6h、12 h後PetCO2與PaCO2間相關性差異有統計學意義(P＜0.05),除12 ml/kg通氣24 h外,a-ADCO2在其餘潮氣量不同時間段均小于5 mmHg,在8 ml/kg時為最低,通氣1h、6h、12 h、24 h分彆為(2.98±0.33)mmHg、(3.28±0.36) mmHg、(3.74±0.28) mmHg、(3.65±0.31) mmHg.結論 PetCO2與PaCO2具有一定的相關性,PetCO2可作為顱腦外傷術後患者機械通氣早期評估PaCO2的手段之一.a-ADCO2在潮氣量為8 ml/kg時最低,可作為呼吸機設置的起始參數之一.PetCO2是顱腦外傷術後患者行機械通氣治療時無創、連續的有效鑑測手段.
목적 연구로뇌외상술후응용궤계통기환자호기말이양화탄분압(partial pressure of end tidal carbon dioxide,PetCO2)여PaCO2상관성급폐포동맥혈이양화탄분압차(alveolar-arterial carbon dioxide tension difference,a-ADCO2)변화규률,탐토PetCO2재로뇌외상술후림상응용개치.방법 입선2012년6월지2014년6월입주ICU일과50례로뇌외상술후응용궤계통기환자,분별우설정조기량6 ml/kg、8 ml/kg、10 ml/kg、12 ml/kg통기1h、6h、12h、24 h후추취동맥혈행혈기분석병기록즉각PetCO2,동시계산a-ADCO2.결과 50례환자불동조기량통기이급궤계통기후1h、6h、12 h후PetCO2여PaCO2간상관성차이유통계학의의(P＜0.05),제12 ml/kg통기24 h외,a-ADCO2재기여조기량불동시간단균소우5 mmHg,재8 ml/kg시위최저,통기1h、6h、12 h、24 h분별위(2.98±0.33)mmHg、(3.28±0.36) mmHg、(3.74±0.28) mmHg、(3.65±0.31) mmHg.결론 PetCO2여PaCO2구유일정적상관성,PetCO2가작위로뇌외상술후환자궤계통기조기평고PaCO2적수단지일.a-ADCO2재조기량위8 ml/kg시최저,가작위호흡궤설치적기시삼수지일.PetCO2시로뇌외상술후환자행궤계통기치료시무창、련속적유효감측수단.
Objective To investigate the correlation between partial pressure of end tidal carbon dioxide (PetCO2)and arterial pressure of carbon dioxide (PaCO2),study the variation of a-ADCO2 and to evaluate the clinical value of PetCO2 in postoperative traumatic brain injury patients with mechanical ventilation therapy.Methods Fifty postoperative traumatic brain injury patients from May 2012 to May 2014 received mechanical ventilation were involved while tidal volume were set at 6 ml/kg,8 ml/kg,10 ml/kg,12 ml/kg.Arterial blood gas analysis and PetCO2 were tested,and a-ADCO2 was calculated while the patients were treated with mechanical ventilation for 1 hour,6 hours,12 hours and 24 hours.Results PetCO2 were significantly correlated with PaCO2 at different tidal volume when treated with mechanical ventilation for 1 hour,6 hours and 12 hours (P ＜0.05,respectively).a-ADCO2 were all lower than 5 mmHg except mechanical ventilation was set at 12 ml/kg for 24 hours,reaching the minimum at 8 ml/kg.Conclusions PetCO2 was well correlated with PaCO2.Tidal volume setting at 8 ml/kg may be a primary parameter when mechanical ventilation was started.PetCO2 could be a noninvasive continuous and effective monitoring method on postoperative traumatic brain injury patients with mechanical ventilation therapy.
