经皮无创血气监测在危重新生儿中的应用价值

Application of transcutaneous non-invasive blood gas monitoring in critically ill neonates

目的探讨新生儿使用经皮二氧化碳分压(TcPCO_2)及经皮氧分压(TcPO_2)监测的临床应用价值。方法选取2016-04-01~2017-03-31入住新生儿重症监护室的需呼吸支持的危重新生儿44例,进行持续TcPCO_2、TcPO_2监测,将监测结果与动脉血二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)结果进行比较。结果共纳入44例患儿,收集188组数据,Pearson积差相关分析结果显示TcPCO_2与PaCO_2、TcPO_2与PaO_2有良好的相关性,Pearson系数分别为0.886、0.676,P<0.005。结论 TcPCO_2、TcPO_2监测可以准确评估危重新生儿的PaCO_2、PaO_2,特别是PaCO_2。TcPCO_2、TcPO_2持续监测的使用可以减少对危重新生儿的采血次数、疼痛刺激。

Objective To explore the clinical value of transcutaneous carbon dioxide(TcPCO 2)and transcutaneous oxygen(TcPO 2)monitoring on critically ill neonates,especially those in need of respiratory support.Methods The critically ill neonates who needed respiratory support in the neonatal intensive care unit between April 1,2016 and March 31,2017 were selected,and their continuous TcPCO 2 and TcPO 2 monitoring was performed.The results of TcPCO 2 and TcPO 2 measurements were compared with those of arterial carbon dioxide partial pressure(PaCO 2)and arterial oxygen partial pressure(PaO 2).Results A total of 44 neonates were included and 188 sets of data were collected.Pearson′s product-moment correlation showed that there was a good correlation between TcPCO 2 and PaCO 2,TcPO 2 and PaO 2.Pearson coefficient was 0.886 for TcPCO 2 and PaCO 2,and 0.676 for TcPO 2 and PaO 2,P<0.005.Conclusion TcPCO 2 and TcPO 2 monitoring provides more accurate estimate of PaCO 2 and PaO 2 for critically ill neonates,especially PaCO 2.The use of continuous TcPCO 2 and TcPO 2 monitoring can reduce the number of blood collection and painful stimulus for critically ill neonates.