呼气末二氧化碳监测在新生儿重症肺炎机械通气中的应用分析

目的 分析呼气末二氧化碳监测在新生儿重症肺炎（SP）机械通气中的应用价值.方法 以安徽省铜陵市人民医院2011年12月～2012年12月收治的26例行机械通气的SP新生儿为研究对象,对26例患儿行持续主流呼气末二氧化碳（PetCO2）监测,同时做125例次动脉血气分析,分析PetCO2与动脉二氧化碳分压（PaCO2）的关系.结果 PetCO2的平均值为（31.9±5.1）nun Hg,PaCO2的平均值为（37.8±4.3）mm Hg,呈正相关（r=0.72,P＜0.05）;随着OI值的升高,PaCO2与PetCO2的相关系数越小,OI超过25时,两者无相关性;23例患儿在机械通气治疗后3、12、24、48及72 h PaCO2与PetCO2呈显著正相关,且随着患儿机械通气时间的延长、病情改善,PaCO2与PetCO2相关性系数呈升高趋势,a-PetCO2不断降低.结论 在对SP患儿进行机械通气时,无创性主流式PetCO2监测在OI值＜25或患儿病情好转时与PaCO2具有较好的相关性,具有临床应用价值.

Application analysis of tidal carbon dioxide monitoring in the mechanical ventilation of neonatal intensive pneumonia

Objective To analyze the application value of the end-tidal carbon dioxide monitoring in mechanical ventilation in newborns with severe pneumonia （SP）.Methods 26 cases of mechanical ventilation SP newborn for the study were treated in Tongling People＇s Hospital from December 2011 to December 2012.26 children underwent continuous the mainstream of the end expiratory carbon dioxide （PetCO2） monitoring.At the same time underwent 125 cases of arterial blood gas analysis.PetCO2 and arterial carbon dioxide partial pressure （PaCO2） were analyzed.Results The average value of PetCO2 was （31.9±5.1） mm Hg,average value of PaCO2 was （37.8±4.3） mm Hg,there was a positive correlation （r =0.72,P ＜ 0.05）.With the rise of the values of OI,the correlation coefficient was smaller between PaCO2 and PetCO2.The Ol over 25,there was no correlation between the two values.23 patients treated with mechanical ventilation after 3,12,24,48 and 72 h,PaCO2 and PetCO2 had a significant positive correlation with the extension of the duration of mechanical ventilation in children with the condition improved,the PaCO2 and PetCO2 correlation coefficient showed an increasing trend.Conclusion Non-invasive the mainstream PetCO2 monitoring and PaCO2 has a good correlation in OI value ＜ 25 or the children get better in SP children with mechanical ventilation.