呼气末二氧化碳分压监测在小儿麻醉中的评价

Evaluation of P_(ET) CO_2 measurements in pediatric anesthesia

目的 :探讨各年龄段小儿呼气末二氧化碳分压 (PETCO2 )和 Pa CO2 的相关性和其差值 (Pa- ETCO2 ) ,评价 PETCO2 是否能准确监测 Pa CO2 。方法 :80例小儿按体重分组 :A组 (≤ 5 kg)、B组 (6～ 10 kg)、C组(11～ 15 kg)和 D组 (16～ 2 5 kg)。无重吸入回路通气 30 m in以上 ,做血气分析测 Pa CO2 ,同时用气管导管近端旁气流法测 PETCO2 计算 Pa- ETCO2 和两者的相关性。结果 :Pa- ETCO2 在 A、B、C、D组分别为 (1.0 3± 0 .5 2 )k Pa、(0 .72± 0 .40 ) k Pa、(0 .32± 0 .31) k Pa和 (0 .30± 0 .2 1) k Pa。体重 5 kg以上小儿 ,PETCO2 和 Pa CO2相关性良好 ,但 5 kg以下小儿相关性差。结论 :用无重吸入回路通气小儿 ,PETCO2 在体重 5 kg以上小儿可代表Pa CO2 ,而在 5 kg以下的婴儿和新生儿则不能准确反映 Pa CO2 。

Objective:The correlations between P ET CO 2 and PaCO 2,and Pa ET CO 2 were investigated to determine whether P ET CO 2 could accurately estimate PaCO 2 in children,infants and neonates.Methods:Eighty cases were divided into four groups according to the weight ≤5kg,6～10kg,11～15kg and 16～25kg. The blood gas of PaCO 2 was obtained after 30 min of ventilation with no rebreathing pediatric circle system and compared with P ET CO 2 sampled from the connector of proximal endotracheal tube.Results:The Pa ET CO 2 was (1.03±0.52)kPa,(0.72±0.40)kPa,(0.32±0.31)kPa and (0.30±0.21)kPa in children with weight ≤5kg,6～10kg,11～15kg and 16～25kg respectively. There was significant correlation between P ET CO 2 and PaCO 2 in children with weight >5kg(P<0.01), however,no cor relation was found in baby with weight≤5kg(P>0.05).Conclusion:During ventilation with non rebreathing circle system,PaCO 2 can be accurately assessed by P ET CO 2 from the proximal endotracheal tube in children with weight >5kg, but not in infants and neonates with weight≤5kg.