CO2波形用于评价单肺通气时肺泡及氧合功能的临床研究

目的 评价PETCO2监测中CO2波形在单肺通气麻醉期间对肺泡通气及氧合功能的临床指导作用.方法 选择拟在右侧开胸手术患者30例,ASA Ⅰ或Ⅱ级,年龄43～75岁.丙泊酚1.5～2 mg/kg、芬太尼2μg/kg、和维库溴铵0.2 mg/kg麻醉诱导后37～39 F双腔气管导管插管,左侧体位下听诊法证实双肺通气和隔离...

Evaluation of the clinical significance of CO2 waveform monitoring on the alveolar function and oxygenation during OLV in thoracic anesthesia

Objective To evaluate the clinical application value of expiratory CO2 waveform monitoring on the alveolar and oxygenation function during left-sided one-lung ventilation(OLV) in thoracic surgery.Methods 30 ASA physical status Ⅰ-Ⅱ patients aged 43～75 undergoing thoracic surgery for which a period of left-sided one-lung ventilation were enrolled in this study.Study was undertaken in all patients after standardized induction of anesthesia and muscle relaxation,and two consecutive parameters in OLV were carried out by preset parameters(PP) and adjustable parameters(AP) in a specified order of seniority.Setting parameters of OLV included VT,RR,I:E and PEEP;AP for setting OLV parameters was based on CO2 waveform,which was similar to two lung ventilation(as basic waveform).The CO2 waveform was analysed in two lung ventilation,with PP setting and AP setting patients during OLV through a SpO2 change.The BP,HR,SpO2 and ventilation parameters value were recorded and observed before and after OLV,when SpO2≤93,after CPAP and after AP setting from both AP setting and PP setting,and statistic analysis was performed.Results CO2 waveform in PP setting showed significant difference after OLV as compared with the basic waveform;there was significant decrease in SpO2(SpO2≤90%)in PP onset period(18.5±3.7min).The SpO2 was lowered again(SpO2≤93%)in PP setting after ventilated with continuous positive airway pressure(CPAP) to two lungs,where hypoxemia during OLV might be treated causally by correcting the parameters of OLV according to the basic waveform,and SpO2 were kept at normal levels in AP setting.Each parameter value for AP setting during OLV after regulation according to basic waveform was significantly different from that for PP setting(P <0.05).Conclusion CO2 waveform monitoring can provide more guidance for the alveolar function and oxygenation during OLV in thoracic anesthesia.