新生儿自主呼吸时鼻前庭内呼气末二氧化碳分压与动脉血二氧化碳分压的相关性

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Abstract [Abstract] Objective To understand the correlation between end-tidal carbon dioxide partial pressure (PetCO2) and arterial partial pressure of carbon dioxide (PaCO2) in nasal vestibule of spontaneously breathing neonates, and verify the reliability of PetCO2 in reflecting PaCO2 in spontaneously breathing neonates. Methods From May 2014 to July 2015, 85 spontaneously breathing hospitalized neonates were randomly selected in Neonatal Medical Center of Huai'an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University Medical Academy. PetCO2 values in nasal vestibule were recorded, while extracting radial arterial for blood gas analysis. According to gestational age, neonates were divided into preterm group (39 cases) and term infant group (46 cases); according to the presence of respiratory system disease, neonates were divided into respiratory disease group (25 cases) and without respiratory disease group (60 cases). PaCO2 and PetCO2 levels were compared by t test and correlated using Pearson correlation. Results The overall average mean value of PetCO2 was lower than that of PaCO2 [(37.6±6.3) vs (40.2±7.4) mmHg, t = 2.406, P = 0.017] (1 mmHg=0.133 kPa). There was a good correlation between PetCO2 and PaCO2 levels among all paired samples (r = 0.947, P = 0.000). PetCO2 of the preterm group was lower than PaCO2, there was no statistically significant difference (t = 1.314, P = 0.193). PetCO2 of the term infant group was lower than PaCO2, the difference was statistically significant (t = 2.032, P = 0.045). The difference between PetCO2 and PaCO2 levels was significant only in the respiratory disease group [(40.1±6.2) vs (45.0±7.6) mmHg, t = 2.494, P = 0.016], but not in the without respiratory disease group [(36.6±6.1) vs (38.4±6.2) mmHg, t = 1.368, P = 0.174]. The correlation between PetCO2 and PaCO2 in the respiratory disease group (r = 0.920, P = 0.000) was lower than that in the without respiratory disease group (r = 0.980, P = 0.000). The difference of PaCO2 and PetCO2 [P(a-et)CO2] in the respiratory disease group [(4.9±2.1) mmHg] was higher than that of the without respiratory disease group [(1.8±0.8) mmHg], and the difference was statistically significant (t = 9.901, P = 0.000). Conclusion PetCO2 of nasal vestibule can provide an accurate and noninvasive estimate of PaCO2 levels in spontaneously breathing neonates, especially in the neonates without respiratory disease.

Key words： [Key words] Neonate Nasal vestibule End-tidal carbon dioxide partial pressure Arterial partial pressure of carbon dioxide

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	MA Bingsong1
	2 SUN Dianjun1 GAO Zibo1 HU Jinhui1 HUA Shaodong3 WU Rong1▲

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MA Bingsong1,2 SUN Dianjun1 GAO Zibo1 HU Jinhui1 HUA Shaodong3 WU Rong1▲. Correlation between end-tidal carbon dioxide partial pressure and arterial partial pressure of carbon dioxide in nasal vestibule of the spontaneously breathing neonates[J]. 中国医药导报, 2016, 13(3): 106-109.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2016/V13/I3/106

[参考文献]
[1] Fabres J，Carlo WA，Phillips V，et al. Both extremes of arterial Carbon dioxide pressure and the magnitude of fluctuations in arterial Carbon dioxide pressure are associated with severe intraventricular hemorrhage in preterm infants [J]. Pediatrics，2007，119（2）：299-305.
[2] Resch B，Neubauer K，Hofer N，et al. Episodes of hypocarbia and early-onset sepsis are risk factors for cystic periventricular leukomalacia in the preterm infant [J]. Early Hum Dev，2012，88（1）：27-31.
[3] Noori S，Andemon M，Soleymani S，et al. Effect of carbon dioxide on cerebral blood flow velocity in preterm infants during postnatal transition [J]. Acta Paediatr，2014，103（8）：334-339．
[4] Keszler M. State of the art in conventional mechanical ventilation [J]. Perinatol，2009，29（4）：262-275.
[5] Chemtob S，Honore JC，Kooli A，et al. Sustained hypercapnia induces cerebral microvascular degeneration in the immaturebrain through induction of nitrative stress [J]. Am J Physiol Regul Integr Comp Physiol，2010，298（6）：1522-1530.
[6] Hauspurg AK，Allred EN，Vanderveen DK，et al. Blood gases and retinopathy of prematurity：the ELGAN study [J]. Neonatology，2010，99（2）：104-111.
[7] Leske DA，Wu J，Fautsch MP，et al. The role of VEGF and IGF-1 in a hypercarbic oxygen- induced retinopathy rat model of ROP [J]. Mol Vis，2004，10（6）：43-50.
[8] Hermansen MC，Hermansen MG. Intravascular catheter complications in the neonatal intensive care unit [J]. Clin Perinatol，2005，32（1）：141-156.
[9] 郝小清，武荣，郑国方，等.呼气末二氧化碳分压在早产儿RDS病程中的变化[J].中华围产医学杂志，2013，16（10）：616-618.
[10] 邵肖梅，叶鸿瑁，丘小汕，等.实用新生儿学[M].4版.北京：人民卫生出版社，2011：45-46.
[11] Colman Y，Krauss B. Microstream capnography technology：a new approach to an old problem [J]. Clin Monit，1999，15（6）：403-409.
[12] Tai CC，Lu FL，Chen PC，et al. Noninvasive capnometry for end-tidal carbon dioxide monitoring via nasal cannula in nonintubated neonates [J]. Pediatr Neonatol，2010， 51（6）：330-335.
[13] 武荣，胡金绘，查丽，等.早产儿机械通气状态下呼气末二氧化碳分压的目标调节范围[J].中华实用儿科临床杂志，2015，30（2）：134-136.
[14] Singh SB，Gilbert U，Singh S，et al. Sidestream microstream end tidal carbon dioxide measurements and blood gas correlations in neonatal intensive care unit [J]. Pediatric Pulmonology，2013，48（3）：250-256.
[15] Bhat YR，Abhishek N. Main stream end-tidal carbon dioxide monitoring in ventilated neonates [J]. Singapore Med J，2008，49（3）：199-203.
[16] 杨少华，杨军，肖昕，等.主流呼气末二氧化碳动态监测在机械通气早产儿呼吸窘迫综合征中的应用[J].中国新生儿科杂志，2009，24（2）：101-104.
[17] Kugelman A，Zeiger-Aginsky D，Bader D. A novel method of distal end-tidal CO2 capnography in intubated infants：comparison with arterial CO2 and with proximal mainstream end-tidal CO2 [J]. Pediatrics Volume，2008，122（6）：1219-1224.
[18] Hagerty JJ，Kleinman ME，Zurakowski D，et al. Accuracy of a new low-flow sidestream capnography technology in newborns：a pilot study [J]. J Perinatol，2002，22（3）：219-225.
[19] Tingay DG，Stewart MJ，Morley CJ. Monitoring of end tidal carbon dioxide and transcutaneous carbon dioxide during neonatal transport [J]. Arch Dis Child Fetal Neonatal Ed，2005，90（6）：523-526.
[20] Tobias JD，Flanagan JF，Wheeler TJ，et al. Noninvasive monitoring of end-tidal CO2 via nasal cannulas in spontaneously breathing children during the perioperative period [J]. Crit Care Med，1994，22（11）：1805-1808.
[21] Belpomme V，Ricard-Hibon A，Devoir C，et al. Correlation of arterial PCO2 and PETCO2 in prehospital controlled ventilation [J]. Am J Emerg Med，2005，23（7）：852-859.
[22] Benallal H，Busso T. Analysis of end-tidal and arterial PCO2 gradients using a breathing model [J]. Eur J Appl Physiol，2000，83（4）：402-408.
[23] Aliwalas LL，Noble L，Nesbitt K，et al. Agreement of carbon dioxide levels measured by arterial，transcutaneous and end tidal methods in preterm infants ≤ 28 weeks gestation [J]. Perinatol，2005，25（6）：26-29.