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首页> 外文期刊>Surgical Endoscopy >Capnographic monitoring for carbon dioxide insufflation during endoscopic mucosal dissection: Comparison of transcutaneous and end-tidal capnometers
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Capnographic monitoring for carbon dioxide insufflation during endoscopic mucosal dissection: Comparison of transcutaneous and end-tidal capnometers

机译：内窥镜黏膜剥离术中二氧化碳吹入的二氧化碳监测：经皮和潮气末二氧化碳监测仪的比较

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Background: The use of carbon dioxide (CO 2) insufflation during endoscopic procedures is effective in reducing patient discomfort caused by bloating. However, transcutaneous arterial CO 2 (PtCO 2) monitoring usually is required for safety during long endoscopic procedures. To evaluate a new capnometer for monitoring end-tidal carbon dioxide (EtCO 2) concentrations and to compare PtCO 2 with EtCO 2 measured in the same patient, a prospective comparative study of EtCO 2 and PtCO 2 values measured simultaneously was designed. Methods: The study enrolled 20 consecutive patients (18 men and two women; mean age, 70.1 years) with upper gastrointestinal neoplasms scheduled for endoscopic submucosal dissection (ESD) using conscious sedation with CO 2 insufflation, and EtCO 2 and PtCO 2 were simultaneously measured by each capnometer. Patient status was evaluated before ESD by the American Society of Anesthesiologists (ASA) physical status classification system, and eight patients were judged as class 1, nine patients as class 2, and three patients as class 3. The exclusion criteria ruled out patients with chronic obstructive pulmonary disease or ASA class 4 or 5 physical status. The correlation between EtCO 2 and PtCO 2 values and the availability of EtCO 2 capnography were investigated. Results: The mean EtCO 2 value during ESD was 34.7 ± 4.5 mmHg, and the mean PtCO 2 value was 51.6 ± 2.4 mmHg. There was a statistically significant correlation between EtCO 2 and PtCO 2 (r = 0.331; P = 0.002). Hypoxic events (90% oxygen saturation [SpO 2]) caused by decreased respiratory rate occurred for 12 patients. In 10 (83%) of 12 events, a significant reduction in EtCO 2 was seen before the decrease in SpO 2. Conclusions: The EtCO 2 values correlated with the PtCO 2 values, and the respiratory monitoring methods allowed earlier detection of hypoxia during ESD with conscious sedation than transcutaneous monitoring. The EtCO 2 capnometer was considered to be available for the ESD procedure with the patient under conscious sedation using CO 2 insufflation.
机译：背景：在内窥镜检查过程中使用二氧化碳（CO 2）吹气可有效减少因腹胀引起的患者不适。但是，通常需要在长期内窥镜检查过程中进行透皮动脉CO 2（PtCO 2）监测，以确保安全。为了评估监测呼气末二氧化碳（EtCO 2）浓度的新型二氧化碳监测仪，并将PtCO 2与同一患者中测得的EtCO 2进行比较，设计了同时测量EtCO 2和PtCO 2值的前瞻性比较研究。方法：本研究连续入选了20例上消化道肿瘤，计划行内镜下黏膜下剥离术（ESD）的上消化道肿瘤患者，采用CO 2吹入有意识的镇静作用，同时测量了EtCO 2和PtCO 2通过每个示波计。在ESD之前，通过美国麻醉医师协会（ASA）身体状况分类系统对患者状况进行了评估，并判断8例患者为1级，9例患者为2级，3例患者为3级。排除标准排除了慢性患者阻塞性肺疾病或ASA 4或5级身体状况。研究了EtCO 2和PtCO 2值之间的相关性以及EtCO 2二氧化碳图的可用性。结果：ESD期间的平均EtCO 2值为34.7±4.5 mmHg，平均PtCO 2值为51.6±2.4 mmHg。 EtCO 2和PtCO 2之间存在统计学上的显着相关性（r = 0.331; P = 0.002）。 12例患者发生了由呼吸频率降低引起的低氧事件（<90％氧饱和度[SpO 2]）。在12个事件中的10个（83％）中，在SpO 2降低之前，EtCO 2显着减少。结论：EtCO 2值与PtCO 2值相关，并且呼吸监测方法允许在ESD期间更早发现缺氧有意识的镇静比经皮监测。 EtCO 2二氧化碳监测仪被认为适用于ESD手术，患者可以在有CO 2吹入的情况下进行有意识的镇静。

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