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
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%.
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。
