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首页> 外文期刊>Anaesthesia: Journal of the Association of Anaesthetists of Great Britain and Ireland >Arterial to end-tidal carbon dioxide difference in children undergoing mechanical ventilation of the lungs during general anaesthesia
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Arterial to end-tidal carbon dioxide difference in children undergoing mechanical ventilation of the lungs during general anaesthesia

机译：在全身麻醉期间肺部机械通风的儿童末端潮汐二氧化碳差异

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Capnography (ETCO2) is routinely used as a non-invasive estimate of arterial carbon dioxide (PaCO2) levels in order to modify ventilatory settings, whereby it is assumed that there is a positive gap between PaCO2 and ETCO2 of approximately 0.5 kPa. However, negative values (ETCO2 > PaCO2) can be observed. We retrospectively analysed arterial to end-tidal carbon dioxide differences in 799 children undergoing general anaesthesia with mechanical ventilation of the lungs in order to elucidate predictors for a negative gap. A total of 2452 blood gas analysis readings with complete vital sign monitoring, anaesthesia gas analysis and spirometry data were analysed. Mean arterial to end-tidal carbon dioxide difference was -0.18 kPa (limits of 95% agreement -1.10 to 0.74) and 71.2% of samples demonstrated negative values. The intercept model revealed PaCO2 to be the strongest predictor for a negative PaCO2-ETCO2 difference. A decrease in PaCO2 by 1 kPa resulted in a decrease in the PaCO2-ETCO2 difference by 0.23 kPa. This study demonstrates that ETCO2 monitoring in children whose lungs are mechanically ventilated may paradoxically lead to overestimation of ETCO2 (ETCO2 > PaCO2) with a subsequent risk of unrecognised hypocarbia.
机译：谱图（ETCO2）常规用作动脉二氧化碳（PACO2）水平的非侵入性估计，以便改变通风环境，由此假设PACO2和ETCO2之间的正隙约为0.5kPa。但是，可以观察到负值（EtCO2> PACO2）。我们回顾性分析了799例肺部经历过的799名儿童的末端二氧化碳差异的动脉，以便肺的机械通风，以阐明负差距的预测因子。分析了共2452例血气分析读数，具有完全生命的符号监测，麻醉气体分析和肺活量数据。平均动脉对终潮二氧化碳差异为-0.18 kPa（95％协议的限制-1.10至0.74），71.2％的样品显示出负值。截距模型揭示了PACO2是负paco2-etco2差异的最强预测因子。 PACO2减少1kPa的降低导致PACO2-etco2差异减少0.23kPa。该研究表明，肺部机械通风的儿童中的ETCO2监测可能矛盾地导致ETCO2（ETCO2> PACO2）的估计，随后的未被识别的缺钙风险。

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