主流呼气末二氧化碳分压监测在新生儿呼吸窘迫综合征中的应用

目的 探讨呼气末二氧化碳分压监测在新生儿呼吸窘迫综合征(NRDS)中应用的可行性.方法 对23例气管插管机械通气的NRDS早产儿进行持续主流呼气末二氧化碳分压(PetCO_2)监测,并同时配对检测112例次动脉血气分析,比较呼气末二氧化碳分压与动脉二氧化碳分压(PaCO_2)的关系.结果 112例次NRDS早产儿动脉血气分析PaCO_2平均为(38.2±5.6)mm Hg(1 mm Hg=0.133 kPa),对应的PetCO_2平均为(32.4±4.9)mm Hg,两者差异显著.肺部病变较轻者(Ⅱ级NRDS)比肺部病变较严重者(Ⅲ级、Ⅳ级NRDs)PetCO_2更能准确地反映PaCO_2的状况.结论 无创性主流呼气末二氧化碳分压监测适用于气管插管机械通气的NRDS的早产儿,能较准确地反映PaCO_2的水平,从而减少血气分析抽血,减轻护理工作量及患儿痛苦.但对重型NRDS的应用有局限性.

The clinical application of dynamic monitoring of mainstream end-tidal carbon dioxide in neonatal respiratory distress syndrome

Objective To study the clinical application of dynamic monitoring of mainstream endtidal carbon dioxide in neonatal respiratory distress syndrome.Methods All of 23 premature neonates diagnosed with NRDS and placed on mechanical ventilation were admitted in this study.Their PetCO_2 was continuously monitored and paired with PaCO_2 at 112 different time points.The correlation between PetCO_2and PaCO_2 was compared.Results This study showed that the average PaCO_2 measured for 112 times was(38.2±5.6)mm Hg(1 mm Hg=0.133kPa)and the corresponding PetCO_2 was,(32.4±4.9)mm Hg;it also showed that PetCO_2 was positively correlated with PaCO_2 and PetCO_2 was even more closely correlated with PaCO_2 in infants with second degree of NRDS than in patients with third and fourth degree of NRDS.Conclusions Dynamically monitoring mainstream PetCO_2 is applicable in mechanically ventilated premature infants with NRDS,it can accurately reflect the level of PaCO_2;Thereby reducing the blood gas analysis,thus reducing the suffering of nursing workload and children.But it has limited significance in cases of severe NRDS.