主流和旁流呼气末二氧化碳与动脉二氧化碳一致性研究  

Disparity between mainstream and sidestream end-tidal carbon dioxide values and arterial carbon dioxide levels

作　　者：王金荣[1] 高攀[1] 邵立业 郭淑芬[1] 郭伟[1] 刘亚晶[1] 崔朝勃[1] 

机构地区：[1]河北医科大学附属衡水哈励逊国际和平医院重症医学科,053000

出　　处：《国际呼吸杂志》2017年第13期1006-1009,共4页International Journal of Respiration

摘　　要：目的评估主流和旁流呼气末二氧化碳分压（PETCO2）与PaCO2的一致性。方法前瞻性收集228例接受有创机械通气患者的临床资料，每例患者进行动脉血气分析时，同时分别采用主流和旁流PETCO2监测仪采集数据并记录，用Bland—Altman方法评估主流和旁流PETCO2与PaCO2的一致性，一致性界限设定在±5mmHg。结果患者年龄（60．43士14．28）岁，PaCO2值为（50．64±24．98）mmHg，主流PETCO2为（46．18±24．45）mmHg，旁流PETCO2均值为（44．36±23．36）mmHg。Bland—Altman一致性分析显示，PaCO2与主流PETC02均值相差4．5mmHg（95％CI-1．6～10．5mmHg），具有一致性。PaCO2与旁流PETCO2均值相差6．3mmHg（95％CI-0．1～12．7mmHg），不具有一致性。主流与旁流PETCO2均值相差1．8mmHg（95％CI-0．4～4．0mmHg），一致性良好。受试者工作曲线分析，主流和旁流PETCO2正常范围截断值分别是31．90～39．20mmHg和30．68～37．70mmHg。结论接受有创机械通气的患者主流PETCO2与PaCO2、主流与旁流PETCO2具有一致性，旁流PETCO2与PaCO2不具有一致性。Objective To assess the agreement between the PaCO2 values and end-tidal carbon dioxide （PETCO2） performed by mainstream and sidestream. Methods A total of 228 subjects with invasive mechanical ventilations were enrolled in a prospective observational study. PETCO2 measured by mainstream and sidestream methods were performed when arterial blood gas were analysed. Agreements between PETCO2 and PaCO2 values were evaluated using the Bland-Airman method. The acceptable limit of agreements was determined to be 5 mmHg. Results The mean age was （60.43 ± 14.28） years. The mean PaCOz was （50.64 ± 24.98） mmHg. The mainstream PETCO2 was （46.18 ± 24.45） mmHg, and the sidestream PETCO2 was （44.36 ±23.36） mmHg. Bland-Altman analysis showed an average difference of 4.5 mmHg （95% limits of agreement-1.6 to 10.5） between mainstream PETCO2 and PaCO2 values. The average difference was 6.3 mmHg （95% limits of agreement-0.1 to 12.7 mmHg） between the sidestream PETCO2 and PaCO2 values. The average difference was 1.8 mmHg （95% limits of agreement-0.4-4.0 mmHg） between the mainstream PETCO2 and sidestream PETCO2. Conclusions This study revealed an agreement between noninvasive PETCO2 measurements and PaCO2 values, but no agreement between sidestream methods and PaCO2 values.

关 键 词：呼气末二氧化碳 动脉二氧化碳 主流 旁流 一致性 

分 类 号：R459.7[医药卫生—急诊医学]