呼气末二氧化碳分压监测在新生儿呼吸窘迫综合征机械通气中的应用

The application of end-tidal carbon dioxide partial pressure monitoring in the mechanical ventilation of neonatal respiratory distress syndrome

目的：探讨呼气末二氧化碳分压（PETCO2）监测在新生儿呼吸窘迫征（NRDS）机械通气中的应用价值。方法：以30例行机械通气的NRDS患儿为观察对象,监测持续主流PETCO2,同时作122例次动脉血气分析,分析PETCO2与动脉二氧化碳分压（PaCO2）的关系。结果：PETCO2与PaCO2的平均值分别为（31.7±5.3）mmHg、（37.6±4.5）mmHg,呈正相关（P〈0.01）;随着氧合指数（OI）值的升高,PaCO2与PETCO2的r值逐渐变小,OI值〉25时,两者之间无相关性;机械通气治疗后12-72 h PaCO2与PETCO2均呈显著正相关关系（P〈0.01）,两者差值不断降低。30例中,存活27例,病死3例。结论：在对NRDS患儿进行机械通气时,无创性主流式PETCO2监测在OI值〈25或患儿病情好转时与PaCO2具有较好的相关性,具有临床应用价值。

Objective： To explore the application value of end-tidal carbon dioxide partial pressure（ PETCO2） monitoring in mechanical ventilation of neonatal respiratory distress syndrome（ NRDS）. Methods： The PETCO2 and 122 arterial blood gas of 30 cases with NRDS treated with mechanical ventilation were monitored. The relation of PETCO2 and arterial carbon dioxide partial pressure（ PaCO2） were analyzed. Results： The average value of PETCO2 and PaCO2were（ 31. 7 ± 5. 3） mmHg and（ 37. 6 ± 4. 5） mmHg,respectively,which was a positive correlation（ P〈0.05）. With the increasing of oxygenation index（ OI） value,the r values of PETCO2 and PaCO2were decreased. When the OI value was more than 25,there was no correlation between PaCO2 and PETCO2. PaCO2 and PETCO2was positive correlation after mechanical ventilation,the difference of which were decreased. Twenty-seven cases survived,and three cases died.Conclusions： When the OI value is less than 25 or children with NRDS get better,the PETCO2 and PaCO2has a good correlation during the period of mechanical ventilation.