Volumetric capnography: lessons from the past and current clinical applications.
Volumetric capnography: lessons from the past and current clinical applications.
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DOI：
10.1186/s13054-016-1377-3
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发表时间：
2016-06-23
期刊：
影响因子：
--
通讯作者：
Magder S
中科院分区：
文献类型：
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作者：
Verscheure S;Massion PB;Verschuren F;Damas P;Magder S
死腔是呼吸-灌流异常的重要组成部分。死腔的测量具有诊断、预后和治疗的应用。在重症监护病房(ICU)，死腔测量可用于指导急性呼吸窘迫综合征(ARDS)患者的治疗；在急诊科，死腔测量可指导肺栓塞的溶栓治疗；在围手术期患者，死腔测量可指示复诊操作的成功。一种名为容量二氧化碳描记术(VCAP)的新技术可以在床边定期测量生理和肺泡死腔。我们讨论了死腔的组成，解释了Bohr和Enghoff方法之间的重要区别，讨论了动脉到呼气末二氧化碳梯度的临床意义，最后总结了在急诊室、手术室和ICU进行VCAP测量的潜在临床适应症。
Dead space is an important component of ventilation–perfusion abnormalities. Measurement of dead space has diagnostic, prognostic and therapeutic applications. In the intensive care unit (ICU) dead space measurement can be used to guide therapy for patients with acute respiratory distress syndrome (ARDS); in the emergency department it can guide thrombolytic therapy for pulmonary embolism; in peri-operative patients it can indicate the success of recruitment maneuvers. A newly available technique called volumetric capnography (Vcap) allows measurement of physiological and alveolar dead space on a regular basis at the bedside. We discuss the components of dead space, explain important differences between the Bohr and Enghoff approaches, discuss the clinical significance of arterial to end-tidal CO2 gradient and finally summarize potential clinical indications for Vcap measurements in the emergency room, operating room and ICU.