经皮二氧化碳分压及氧分压监测在新生儿重症监护病房临床应用进展

Resent progress in the clinical application of transcutaneous oxygen and carbon dioxide partial pressure monitoring in NICU

动脉血二氧化碳分压(Pa CO2)和氧分压(Pa O2)是新生儿重症监护病房(NICU)最常用的评估指标,其结果需通过采集动脉血或末梢血方式进行血气分析而获得。由于病情需要,多数患儿往往需反复穿刺采集标本,不仅导致新生儿罹患感染概率增加,甚至造成医源性贫血等。经皮氧分压(Tc PO2)及经皮二氧化碳分压(Tc PCO2)作为无创血气分析的监测技术,逐渐开始应用于新生儿临床,对于低出生体重儿,特别是极低出生体重儿和超低出生体重儿,在新生儿氧疗、机械通气、休克及低灌注的监测等方面均发挥了重要作用。

PaO2 and PaCO2 monitoring is the most important indicators of ventilation and oxygenation in the NICU. The re- sults of PaO2 and PaCO2 are from blood gas obtained by collect- ing arterial or peripheral blood samples. Repeated blood sam- pling is frequently needed in critically ill neonates, which mayincrease the risk of neonatal infection, iatrogenic anemia and pain stress. TcPCO2 and TcPO2, as the noninvasive monitors, have been emerging as non-invasive blood gas monitoring in the clinical care of critically ill neonates, especially the VLBW and ELBW infants, during neonatal oxygen therapy, mechanical ventilation and shock requiring perfusion monitoring.