呼气末二氧化碳分压监测在小儿机械通气中的应用

目的　探讨小儿不同心肺疾病条件下机械通气的特点及呼气末二氧化碳分压 (PetCO2 )与动脉血二氧化碳分压 (PaCO2 )的相关性及其影响因素。方法　选择 10 2例小儿根据心肺疾病不同分三组 ,无心肺疾患组 18例 ,月龄11.2± 7.5。严重肺部疾病组 10例 ,月龄 14 .3± 6.5 ,严重的先天性心脏病术后用呼吸机支持的患儿 74例 ,月龄 2 0 .3±9.3。监测方法 :呼吸机应用 1小时后患儿安静状态下采取动脉血气标本 ,并记录即刻PetCO2 ,计算出PaCO2 与PetCO2 差(a—ETCO2 )。结果　三组患儿的PaCO2 与PetCO2 均有显著相关性 (r1=0 .5 83 ,r2 =0 .786,r3 =0 .790 ,P均 >0 .0 5 )。而三组间a—ETCO2 有组间差异 ,其中第 3组与第 1组差异显著。结论　PetCO2 可用于判断小儿机械通气状态下PaCO2的变化 ,PetCO2 是一种有用的无创性指标。

Use of end-tidal carbon dioxide tension monitoring in children during mechanical ventilation

Objective To study the different feature and the relationship and clinical value between end-tidal Carbon dioxide tension(P et CO 2) and P sCO 2 in children with different heartorlung dieases during mechanical ventilation.Methods 102 cases of children were divided into three groups according to different heart or lung diseases,The group without lung and heart diseases were 18 cases (mean age 11.2±7.5months).The group with serious lung diseases were 10 cases (mean age 14.3±6.5months).The group with congenital heart diseases postoperative were 74 cases (mean age 20.3±9.3 months).Arterial blood gas were measured when the artificial ventilation 1 hour,the difference between the P aCO 2 and P et CO 2 (a—ETCO 2) was calculated.Results P et CO 2 were significantly correlated with P aCO 2 in three groups (r1=0.583,r2=0.786,r3=0.790,P>0.05).Conclusions P et CO 2 could reflect the change of P aCO 2 in children during mechanical ventilation.P et CO 2 is a useful non-invasive index.