目的 探讨新生儿机械通气时呼气末二氧化碳分压（PetCO2）和动脉血二氧化碳分压（PaCO2）的相关性。方法 对31例气管插管机械通气的新生儿进行持续主流PetCO2监测，并同时配对检测85例次动脉血血气分析，评估PetCO2与PaCO2的相关性和一致性。结果 31例机械通气新生儿PetCO2均值（41±10 mm Hg）低于PaCO2均值（46±11 mm Hg）（P<0.01），二者具有显著正相关性（r=0.92，P<0.01）；平均偏倚是5.1±4.3 mm Hg，在95%一致性范围是（-3.3，13.6 mm Hg），5%（4/85）的数值在95%的可信区间以外。在氧合指数（OI）<300 mm Hg（n=48）时，PetCO2和PaCO2具有显著正相关性（r=0.85，P<0.01），平均偏倚是5.9±4.3 mm Hg，在95% 一致性范围是（-2.6，14.5 mm Hg），4%（2/48）的数值在95%的可信区间以外。OI≥300 mm Hg（n=37）时，PetCO2和PaCO2也有显著正相关性（r=0.91，P<0.01），平均偏倚是4.1±4.1 mm Hg，在95%一致性范围是（-3.9，12.1 mm Hg），仅5%（2/37）的数值在95%的可信区间以外。结论 在机械通气的新生儿中，PetCO2和PaCO2有较好的相关性和一致性。
Abstract
To study the correlation between end-tidal carbon dioxide (PetCO2) and partial pressure of arterial carbon dioxide (PaCO2) in ventilated newborns. Methods Thirty-one ventilated newborn underwent mainstream PetCO2 monitoring; meanwhile, arterial blood gas analysis was performed. The correlation and consistency between PetCO2 and PaCO2 were assessed. Results A total of 85 end-tidal and arterial CO2 pairs were obtained from 31 ventilated newborns. The mean PetCO2 (41±10 mm Hg) was significantly lower than the corresponding mean PaCO2 (46±11 mm Hg) (P<0.01). There was a significant positive correlation between PetCO2 and PaCO2 (r=0.92, P<0.01). The overall PetCO2 bias was 5.1±4.3 mm Hg (95% limits of consistency, -3.3 to 13.6 mmHg), and 5% (4/85) of the points were beyond the 95%CI. When the oxygenation index (OI) was less than 300 mm Hg (n=48), there was a significant positive correlation between PetCO2 and PaCO2 (r=0.85, P<0.01); the PetCO2 bias was 5.9±4.3 mm Hg (95% limits of consistency, -2.6 to 14.5 mm Hg), and 4.2% (2/48) of the points were beyond the 95%CI. When the OI was more than 300 mm Hg (n=37), there was also a significant positive correlation between PetCO2 and PaCO2 (r=0.91, P<0.01); the PetCO2 bias was 4.1±4.1 mm Hg (95% limits of consistency, -3.9 to 12.1 mm Hg), and 5% (2/37) of the points were beyond the 95%CI. Conclusions There is a good correlation and consistency between PetCO2 and PaCO2 in ventilated newborns.
关键词
动脉血二氧化碳分压 /
呼气末二氧化碳分压 /
机械通气 /
新生儿
Key words
Partial pressure of arterial carbon dioxide /
End-tidal carbon dioxide /
Mechanical ventilation /
Newborn
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