DETECTION OF VENOUS AIR-EMBOLISM - COMPARISON OF OXYGENATION AND VENTILATION MONITORING METHODS IN DOGS
DETECTION OF VENOUS AIR-EMBOLISM - COMPARISON OF OXYGENATION AND VENTILATION MONITORING METHODS IN DOGS
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DOI：
10.1097/00008506-199201000-00007
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发表时间：
1992-01-01
影响因子：
3.7
通讯作者：
GRAYBEAL, JM
中科院分区：
文献类型：
--
作者：
RUSSELL, GB;GRAYBEAL, JM
Venous air embolism (VAE) results in both hypoxemia and hypercapnea with decreased end-tidal carbon dioxide (ETCO2). Relative sensitivities for VAE detection were determined for (a) continuous oxygen saturation monitoring, as measured by pulse oximetry (SaPO2), an arterial fiberoptic catheter (SacO2), and a pulmonary artery (PA) fiberoptic catheter (SvcO2) compared with those determined by arterial and mixed venous blood gas measurements (SabgO2 and SvbgO2, respectively) and (b) continuous ETCO2 and intermittent PaCO2 measurements in eight anesthesized, mechanically ventilated mongrel dogs. Air was infused (in varied order) at 0.05, 0. 10, and 0.20 ml/kg/min for 5 min into the jugular vein. Arterial and mixed venous blood gas tensions were determined prior to and at 2.5, 5, and 10 min after VAE was begun. VAE was diagnosed by a greater-than-or-equal-to 5% decrease in any O2 saturation or a greater-than-or-equal-to 3 mm Hg increase in PaCO2 or decrease in ETCO2. Values obtained were statistically compared by multiple regression analyses, analysis of variance, and Student t tests, where applicable. VAE was detected more readily by decreases in ETCO2 and increases in PaCO2 than decreases in oxygen saturation, as measured by either method. Mean maximal decreases in O2 saturations were 3% for SacO2 at 10 min (p = 0.03), 7% for SaO2 at 5 min (p = 0.01), 8% at 5 min for both SvbgO2 (p = 0.04) and SvcO2 (p = 0.07). There was a significant correlation between each oxygenation measurement technique (p < 0.0001). Venous air infusions of 0.20 ml/kg/min resulted in significant SabgO2, SaCO2, and SvbgO2 decreases. Of the methods tested in this dog model, continuous monitors of systemic and mixed venous oxygenation, but particularly ETCO2, resulted in the most accurate and sensitive VAE detection.
