Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard P...Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard PaO2 value in obese patients in the supine position is unknown. We evaluated the PaO2 with respect to the Broca-Katsura obesity index. Materials and Methods: From January 2001 to December 2013, we evaluated 472 patients aged ≥16 years old that underwent general anesthesia in the supine position. The anesthetic charts of 472 patients with an American Society of Anesthesiologists physical status of I or II were retrospectively reviewed to investigate the PaO2. Results: In patients aged 16 to 2 was 165.7 ± 25.6 mmHg at a Broca-Katsura index of 2 was 152.1 ± 23.8 mmHg at a Broca-Katsura index of 2 tended to decrease with age from 16 to 2 tended to decrease with age from 16 to <65 years at a Broca-Katsura index of 20% to <40%.展开更多
Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performe...Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients（who were admitted to the ICUs of our hospital from January 2000 to December 2009）.Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve（AUC） standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve （AUC） at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.展开更多
Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in ob...Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in obese patients during general anesthesia. Materials and Methods: From January 2003 to December 2013, we studied 601 patients aged 16 years old or over undergoing general anesthesia. Patients had American Society of Anesthesiology physical status I and II and we reviewed their anesthetic charts. The P(a-ET)CO2 with respect to the BKI divided patients into two groups: 16 to 2 values between the two groups. Results: In patients aged 16 to 2 was 2.2 ± 3.1 mmHg at BKI 2 was 3.2 ± 4.1 mmHg at BKI 2 tends to increase in obese patients during general anesthesia with increasing BKI in patients aged 16 to < 65 years old.展开更多
目的:分析不同血循环状态下经皮氧分压(transcutaneous oxygen pressure,PctO_2)与血氧分压(partial pressure of oxygen in arterial blood,PaO_2)、经皮二氧化碳分压(transcutaneous carbon dioxide pressure,PctCO_2)与血二氧化碳分...目的:分析不同血循环状态下经皮氧分压(transcutaneous oxygen pressure,PctO_2)与血氧分压(partial pressure of oxygen in arterial blood,PaO_2)、经皮二氧化碳分压(transcutaneous carbon dioxide pressure,PctCO_2)与血二氧化碳分压(partial pressure of oxygen in arterial blood,PaCO_2)的相关性及差异性,从而了解PctO_2及PctCO_2在微循环障碍时的监测意义。方法:对2014年11月至2015年3月在重庆医科大学附属儿童医院重症医学科住院的56例患儿进行PctO_2/PctCO_2监测,因病情需要,部分患儿不同时段予动态监测,共采集110份数据。分析微循环正常组(n=75)、轻度障碍组(n=20)及重度障碍组(n=15)间PctO_2与PaO_2及PctCO_2与PaCO_2的相关性及差异性。用受试者工作特征曲线(receiver operating characteristics curve,ROC curve)评价PctO_2、PctCO_2诊断低氧血症及二氧化碳潴留的敏感度及特异度。结果:相关性分析:在微循环正常组(n=75),PctO_2与PaO_2、PctCO_2与PaCO_2均有良好相关性(r=0.937、0.569,均P<0.05);在微循环轻度障碍组(n=20)及重度障碍组(n=15),患儿PctCO_2与PaCO_2均具有良好的相关性(r=0.718、0.679,均P<0.05),而PctO_2与PaO_2无相关性(P=0.175、0.074)。氧分压差(△PO2):微循环正常组(n=75)、轻度障碍组(n=20)和重度障碍组(n=15)的△PO2分别为:(0.24±1.08)、(7.99±7.99)和(9.71±5.15)k Pa。ROC曲线分析:微循环正常组(n=75)中,PctO_2在ROC曲线下面积(area under the ROC curve,AUC)为0.89(95%CI=0.82~0.96,P=0.036),PctO_2=10.25 k Pa时诊断缺氧的敏感度是81.5%,特异度是83.3%。PctCO_2的AUC为0.77(95%CI=0.65~0.88,P=0.000),PctCO_2=5.45 k Pa时诊断二氧化碳潴留的敏感度是81.5%,特异度是66.7%。结论:在微循环正常时,PctO_2/PctCO_2监测在一定程度上可预测PaO_2/PaCO_2。在微循环轻度障碍及重度障碍时,PctCO_2监测可预测PaCO_2。PctO_2与PaO_2差别明显时往往提示微循环灌注不良,对于此类危重症患者,可结合PctO_2/PctCO_2监测与血气分析中PaO_2/PaCO_2综合判断。展开更多
文摘Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard PaO2 value in obese patients in the supine position is unknown. We evaluated the PaO2 with respect to the Broca-Katsura obesity index. Materials and Methods: From January 2001 to December 2013, we evaluated 472 patients aged ≥16 years old that underwent general anesthesia in the supine position. The anesthetic charts of 472 patients with an American Society of Anesthesiologists physical status of I or II were retrospectively reviewed to investigate the PaO2. Results: In patients aged 16 to 2 was 165.7 ± 25.6 mmHg at a Broca-Katsura index of 2 was 152.1 ± 23.8 mmHg at a Broca-Katsura index of 2 tended to decrease with age from 16 to 2 tended to decrease with age from 16 to <65 years at a Broca-Katsura index of 20% to <40%.
基金sponsored by Guangdong Science and Technology Project(No:2009B03081118)
文摘Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients（who were admitted to the ICUs of our hospital from January 2000 to December 2009）.Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve（AUC） standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve （AUC） at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.
文摘Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in obese patients during general anesthesia. Materials and Methods: From January 2003 to December 2013, we studied 601 patients aged 16 years old or over undergoing general anesthesia. Patients had American Society of Anesthesiology physical status I and II and we reviewed their anesthetic charts. The P(a-ET)CO2 with respect to the BKI divided patients into two groups: 16 to 2 values between the two groups. Results: In patients aged 16 to 2 was 2.2 ± 3.1 mmHg at BKI 2 was 3.2 ± 4.1 mmHg at BKI 2 tends to increase in obese patients during general anesthesia with increasing BKI in patients aged 16 to < 65 years old.
文摘目的:分析不同血循环状态下经皮氧分压(transcutaneous oxygen pressure,PctO_2)与血氧分压(partial pressure of oxygen in arterial blood,PaO_2)、经皮二氧化碳分压(transcutaneous carbon dioxide pressure,PctCO_2)与血二氧化碳分压(partial pressure of oxygen in arterial blood,PaCO_2)的相关性及差异性,从而了解PctO_2及PctCO_2在微循环障碍时的监测意义。方法:对2014年11月至2015年3月在重庆医科大学附属儿童医院重症医学科住院的56例患儿进行PctO_2/PctCO_2监测,因病情需要,部分患儿不同时段予动态监测,共采集110份数据。分析微循环正常组(n=75)、轻度障碍组(n=20)及重度障碍组(n=15)间PctO_2与PaO_2及PctCO_2与PaCO_2的相关性及差异性。用受试者工作特征曲线(receiver operating characteristics curve,ROC curve)评价PctO_2、PctCO_2诊断低氧血症及二氧化碳潴留的敏感度及特异度。结果:相关性分析:在微循环正常组(n=75),PctO_2与PaO_2、PctCO_2与PaCO_2均有良好相关性(r=0.937、0.569,均P<0.05);在微循环轻度障碍组(n=20)及重度障碍组(n=15),患儿PctCO_2与PaCO_2均具有良好的相关性(r=0.718、0.679,均P<0.05),而PctO_2与PaO_2无相关性(P=0.175、0.074)。氧分压差(△PO2):微循环正常组(n=75)、轻度障碍组(n=20)和重度障碍组(n=15)的△PO2分别为:(0.24±1.08)、(7.99±7.99)和(9.71±5.15)k Pa。ROC曲线分析:微循环正常组(n=75)中,PctO_2在ROC曲线下面积(area under the ROC curve,AUC)为0.89(95%CI=0.82~0.96,P=0.036),PctO_2=10.25 k Pa时诊断缺氧的敏感度是81.5%,特异度是83.3%。PctCO_2的AUC为0.77(95%CI=0.65~0.88,P=0.000),PctCO_2=5.45 k Pa时诊断二氧化碳潴留的敏感度是81.5%,特异度是66.7%。结论:在微循环正常时,PctO_2/PctCO_2监测在一定程度上可预测PaO_2/PaCO_2。在微循环轻度障碍及重度障碍时,PctCO_2监测可预测PaCO_2。PctO_2与PaO_2差别明显时往往提示微循环灌注不良,对于此类危重症患者,可结合PctO_2/PctCO_2监测与血气分析中PaO_2/PaCO_2综合判断。
