CAJ | 학술논문

目的评价气管导管远端采样用于新生儿监测PETCO2的可靠性.方法择期全麻下行腹部手术的足月新生儿50例,年龄1～28 d,体重2.55～4.00 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组(n=25):气管导管近端采样组(P组)和气管导管远端采样组(D组).利用外径为1 mm的硬膜外导管,一端连接二氧化碳采样管,另一端伸入气管导管至其远端侧孔处.机械通气15 min时采集桡动脉血样,记录PETCO2,行血气分析,记录PaCO2;PETCO2与PaCO2作一致性检验.结果 2组PETCO2低于PaCO2(P＜0.01);2组间PaCO2比较差异无统计学意义(P＞0.05);D组PETCO2高于P组(P＜0.01).D组Kappa值高于P组(P＜0.01).结论与气管导管近端采样相比,气管导管远端采样监测新生儿PETCO2更可靠.
목적 평개기관도관원단채양용우신생인감측PETCO2적가고성.방법 택기전마하행복부수술적족월신생인50례,년령1～28 d,체중2.55～4.00 kg,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법분위2조(n=25):기관도관근단채양조(P조)화기관도관원단채양조(D조).이용외경위1 mm적경막외도관,일단련접이양화탄채양관,령일단신입기관도관지기원단측공처.궤계통기15 min시채집뇨동맥혈양,기록PETCO2,행혈기분석,기록PaCO2;PETCO2여PaCO2작일치성검험.결과 2조PETCO2저우PaCO2(P＜0.01);2조간PaCO2비교차이무통계학의의(P＞0.05);D조PETCO2고우P조(P＜0.01).D조Kappa치고우P조(P＜0.01).결론 여기관도관근단채양상비,기관도관원단채양감측신생인PETCO2경가고.
Objective To evaluate the reliability of gas sampling from the distal end of the tracheal tube for partial pressure of end-tidal CO2 (PETCO2) monitoring in neonates.Methods A total of 50 fullterm neonates,scheduled for elective abdominal surgery under general anesthesia,aged 1-28 days,weighing 2.55-4.00 kg,of ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n =25 each) using a random number table:gas samples collected from proximal end of tracheal tube group (group P) and gas samples collected from distal end of tracheal tube group (group D).Epidural catheters of 1 mm in external diameter were used.One end of the catheter was connected to a tube for carbon dioxide sampling,and the other end was inserted into the endotracheal tube and advanced toward the distal hole of the tube.At 15 min of mechanical ventilation,blood samples were collected from the radial artery for record of PETCO2 and for blood gas analysis.Consistency test was performed between PETCO2 and partial pressure of arterial CO2 (PaCO2).Results PET CO2 was significantly lower than PaCO2 in the two groups.There was no significant difference in PaCO2between the two groups.PETCO2 was significantly higher in group D than in group P.Kappa was significantly higher in group D than in group P.Conclusion Gas sampling from the distal end of the tracheal tube is more reliable than gas sampling from the proximal end in monitoring PETCO2 in the neonates.