MEASUREMENT OF TRANSCUTANEOUS CARBON-DIOXIDE IN LOW-BIRTH-WEIGHT INFANTS DURING THE FIRST 2 WEEKS OF LIFE
MEASUREMENT OF TRANSCUTANEOUS CARBON-DIOXIDE IN LOW-BIRTH-WEIGHT INFANTS DURING THE FIRST 2 WEEKS OF LIFE
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DOI：
10.1055/s-2008-1040754
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发表时间：
1994-05-01
影响因子：
2
通讯作者：
HOATH, SB
中科院分区：
文献类型：
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作者：
BINDER, N;ATHERTON, H;HOATH, SB
随着脉搏血氧仪的出现，经皮(TC)血气监测在重症监护环境中的使用已普遍减少。然而，现有的数据表明，动脉二氧化碳分压(PCO2)水平最好是用TC方法估计的。在这项研究中，我们报告了连续32例出生体重小于1500g的2周以下婴儿常规监测二氧化碳分压的经验，共获得644对(二氧化碳分压与动脉二氧化碳分压)。根据传感器温度(40摄氏度或43摄氏度)与动脉采样位置(脐带[UAC]或外周动脉导管[PAC])的2x2矩阵设计对配对进行分类。通过UAC采样，在两个传感器温度下的样本对之间具有良好的相关性，组间具有相似的回归。然而，通过PAC抽样，样本对之间的相关性很差，两个UAC组的回归显著不同。基于这些发现，我们主张在极低出生体重儿中使用40摄氏度的传感器来跟踪TcPCO2值。此外，我们认为，PAC采样的不准确可能导致错误的二氧化碳分压测定。我们得出结论，常规监测二氧化碳分压是准确的，并在新生儿重症监护环境中发挥有用和持续的作用。
With the advent of pulse oximetry, there has been a general decrease in the use of transcutaneous (Tc) blood gas monitoring in intensive care environments. The available data, however, suggest that arterial carbon dioxide pressure (PCO2) levels are best estimated by Tc methods. In this study, we report our experience using routine Tc PCO2 monitoring in 32 consecutive infants less than 2 weeks of age with birthweights less than 1500 g. A total of 644 simultaneous pairs (Tc PCO2 versus arterial PCO2) were obtained. Pairs were categorized according to a 2 x 2 matrix design based on sensor temperature (40 degrees or 43 degrees C) versus site of arterial sampling (umbilical [UAC] or peripheral artery catheter [PAC]). Sampling via the UAC resulted in excellent correlation between sample pairs at both sensor temperatures with similar regressions between groups. Sampling via the PAC, however, yielded poor correlation between sample pairs and a significantly different regression from both UAC groups. Based on these findings, we advocate the use of a sensor temperature of 40 degrees C in very low birthweight infants for tracking Tc PCO2 values. In addition, we suggest that inaccuracies in PAC sampling may lead to erroneous PCO2 determinations. We conclude that routine monitoring of Tc PCO2 is accurate and serves a useful and continuing role in the neonatal intensive care environment.