Carbon Dioxide Elimination and Oxygen Consumption in Mechanically Ventilated Children
Carbon Dioxide Elimination and Oxygen Consumption in Mechanically Ventilated Children
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DOI：
10.4187/respcare.03605
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发表时间：
2015-05-01
期刊：
影响因子：
2.5
通讯作者：
Mehta, Nilesh M.
中科院分区：
文献类型：
--
作者：
Smallwood, Craig D.;Walsh, Brian K.;Mehta, Nilesh M.
背景技术背景：在床旁准确测量二氧化碳消除（（V）/点（CO2））和氧消耗（（V）/点（O2））可能有助于滴定机械通气患者的营养和呼吸支持。现在，许多制冷机都提供连续（V）过点（CO2）监测。然而，由于文献中的规范性数据很少，我们的目的是描述在机械通气儿童中观察到的（V）超过点（CO2）和（V）超过点（O2）值的范围。我们还旨在检查与标准稳态相关的（V）超过点（CO2）值的特征（当（V）超过点（CO2）和（V）超过点（O2）变异性< 10%时为5分钟）。方法：接受间接量热法检测的机械通气患者有资格入选，并且纳入了达到标准稳态的受试者。根据受试者身高对标准化（V）超点（CO2）和（V）超点（O2）值（mL/kg/min）进行建模，并计算相关系数以量化拟合优度。开发了仅使用（V）相对于点（CO2）的稳态定义（（V）相对于点（CO2）的变异性< 5%，持续5分钟），并使用灵敏度和特异性针对标准稳态进行了测试。结果：纳入了来自87项间接测热试验（70名受试者）的稳态数据。对于< 0.5岁、0.5-8岁和> 8岁的年龄组，平均（V）点（CO2）值分别为7.6、5.8和3.5 mL/kg/min。标准化（V）点（CO2）和（V）点（CO2）值与受试者身高和年龄呈负相关。归一化气体交换量与高度的关系为：（V）过点（CO2）= 115 ×（高度cm）（-0.71）（R = 0.61，P
BACKGROUND: Accurate measurement of carbon dioxide elimination ((V) over dot(CO2)) and oxygen consumption ((V) over dot(O2)) at the bedside may help titrate nutritional and respiratory support in mechanically ventilated patients. Continuous (V) over dot(CO2) monitoring is now available with many ventilators. However, because normative data are sparsely available in the literature, we aimed to describe the range of (V) over dot(CO2) and (V) over dot(O2) values observed in mechanically ventilated children. We also aimed to examine the characteristics of (V) over dot(CO2) values that are associated with standard steady state (5-min period when (V) over dot(CO2) and (V) over dot(O2) variability are < 10%). METHODS: Mechanically ventilated patients who underwent indirect calorimetry testing were eligible for inclusion, and subjects who achieved standard steady state were included. Normalized (V) over dot(CO2) and (V) over dot(O2) values (mL/kg/min) were modeled against subject height, and correlation coefficients were computed to quantify the goodness of fit. A steady-state definition using only (V) over dot(CO2) was developed ((V) over dot(CO2) variability of < 5% for a 5-min period) and tested against standard steady state using sensitivity and specificity. RESULTS: Steady-state data from 87 indirect calorimetry tests (in 70 subjects) were included. For age groups < 0.5, 0.5-8, and > 8 y, the mean (V) over dot(CO2) values were 7.6, 5.8, and 3.5 mL/kg/min. Normalized (V) over dot(CO2) and (V) over dot(CO2) values were inversely related to subject height and age. The relationships between normalized gas exchange values and height were demonstrated by the models: (V) over dot(CO2) = 115 x (height in cm)(-0.71) (R = 0.61, P