危重患者呼气末二氧化碳与动脉血二氧化碳的相关性研究

目的:探讨成年患者在急危重状态下呼气末二氧化碳( ETCO2)与动脉血二氧化碳(PaCO2)的相关性.方法:100例ICU患者入院后使用碳酸波形图监测初始ETCO2值,监测完毕迅速抽血做血气分析监测PaCO2值.统计分析ETCO2和PaCO2之间的相关性与一致性,并比较主流法和旁流法监测对ETCO2的影响.结果:100例患者ETCO2平均值为31.32±7.81 mmHg,PaCO2平均值为35.44±8.57 mmHg,ETCO2和PaCO2呈中度相关(r=0.67).Bland-Altman绘图显示PaCO2与ETCO2差值的均值为4.12 mmHg,一致性范围为(-9,+17).主流法和旁流法监测对ETCO2值没有显著影响.结论:碳酸波形图监测的ETCO2不足以准确反映成年患者在急危重状态下PaCO2的变化.

Correlation between end-tidal carbon dioxide and PaCO2 in critically ill adult patients

Objective:To explore the correlation between end-tidal carbon dioxide (ETCO2) and PaCO2 in critically ill adult patients.Methods:Initial ETCO2 of 100 patients were monitored by using capnograph after admitted in ICU.Then blood was taken immediately for gas analysis for monitoring PaCO2 value.The correlation and consistency between ETCO2 and PaCO2 were analyzed, and the effect of ETCO2 monitoring with mainstream and sidestream was compared.Results:The mean value of ETCO2 was 31.32±7.81mmHg,and the mean value of PaCO2 was 35.44±8.57mmHg,the correlation between ETCO2 and PaCO2 was moderate (r= 0.67).The Bland-Altman plots showed the mean difference between the PaCO2 and ETCO2 levels was 4.12 mmHg,the limits of agreement were -9 to +17 mmHg.There was no significant influence on value of ETCO2 with the methods of mainstream and sidestream.Conclusion:ETCO2 monitoring with capnograph does not accurately enough to predict PaCO2 in adult patients in critical condition.