机械通气患者呼气末二氧化碳监测异常的原因分析

The nursing care of the mechanical ventilated patients with PetCO2 monitoring to detect abnormalities and to analyse the reason

目的分析影响机械通气患者呼气末二氧化碳（PetCO2）监测异常的原因，及时发现异常情况，提高机械通气治疗效果。方法对实施机械通气的108例患者PetCO2监测的数值、波形变化及其影响因素进行回顾性分析。结果记录到212例次PetCO2异常波形和数值中，异常发生率为13．4％。其中呼吸环路漏气占30．4％，气管导管位置不当占6．8％，气囊漏气占11．3％，分泌物阻塞占22．4％，通气过度占12．5％，通气不足占7．6％，肺灌注不足占5．8％，机械故障占3．2％。结论机械通气患者通过持续监测PetCO2数值和波形曲线变化，结合心电图进行分析，可及时发现异常情况并采取相应处理措施，提高救治率。

Objective To analyse the clinical situations and other factors that influence the PetCO2 monitoring. The analysis can improve the nursing care for mechanical ventilated patients. Methods To retrospectively analyze 212 PetCO2 monitoring numbers and capnograms in 108 mechanical ventilated patients. Results PetCO2 abnormalities rate was 13.4% ; leakage in the ventilator system was 30. 4% ; endotracheal tube malposition 6. 8% ; endotracheal tube baloon leakage 11.3% ; secreations 22.4% ; hyperventilation 12. 5% ; hypoperfusion 7.6% ; hypoperfusion of the lung 5.8% ; mechanical malfunctioning 3.2%. Conclusions Continue monitoring of PetCO2 and capnogram along with hemodynamic monitoring in mechanical ventilated patients can timely find patients＇ problems and promptly use appropriate interventions. The understanding of these monitoring systems can improve the quality of the nursing care for the critically ill patients.