中国医学装备2025，Vol.22Issue(8)：1-6,16,7.DOI:10.3969/j.issn.1672-8270.2025.08.001
主流与旁流呼气末二氧化碳分压监测技术的准确性及其临床评价研究
Multi dimensional assessment study on the accuracy and clinical application of mainstream and sidestream monitoring technologies for partial pressure of end tidal carbon dioxide in monitoring devices
摘要
Abstract
Objective:To investigate the measurement differences between mainstream and sidestream partial pressure of end tidal carbon dioxide(PetCO2)monitoring techniques in mechanically ventilated patients,as well as the correlation with partial pressure of arterial blood carbon dioxide(PaCO2)and clinical applicability,and to provide a basis for the rational selection of monitoring methods in the clinic.Methods:A total of 169 patients who underwent invasive mechanical ventilation in the operating room of the First Affiliated Hospital of Bengbu Medical University from August to November 2024 were selected to be monitored by three monitoring techniques of mainstream PetCO2,sidestream PetCO2 and PaCO2,respectively,and the 243 sets of valid pairwise data monitored by the three monitoring techniques were recorded,analyzed for correlation and deviation,and performed PaCO2 and PetCO2 were stratified and analyzed.Likert scales were used to analyze the subjective ratings of the 3 monitoring techniques of mainstream PetCO2,sidestream PetCO2,and PaCO2 by the 31 health care professionals who used the study.Results:Both mainstream and sidestream PetCO2 correlated with PaCO2(r=0.554,0.515,P<0.05),and mainstream PetCO2 correlated better than sidestream;mainstream PetCO2 was lower than the concurrent PaCO2 by 6.00 mmHg,and the 95%limit of agreement(95%LoA)was±6.28 mmHg,both lower than that of sidestream by 8.24 mmHg and±7.41 mmHg.8.24 mmHg and±7.41 mmHg.The dispersion of sidestream PetCO2 monitoring values was greater,especially at high PaCO2 levels.Mainstream method PetCO2 had the highest correlation with PaCO2 in gynecologic patients(r=0.820,P<0.05),and sidestream method PetCO2 underestimated PaCO2 more markedly in gastrointestinal and hepato-biliary-pancreatic surgery patients.The deviation of oxygenation index≤300 mmHg was significantly greater than that of patients with oxygenation index>300 mmHg,and the tendency of underestimation was more significant at high PaCO2.31 healthcare experts evaluated that the mainstream PetCO2 monitoring method was outstanding in terms of accuracy and real-time,and that the sidestream method of PetCO2 monitoring was advantageous in terms of ease of operation and management of consumables.Conclusion:In patients who receive mechanical ventilation,the precision,accuracy and real-time of mainstream PetCO2 monitoring are better,which is suitable for patients with rapid changes in disease condition or patients at risk of hypercapnia.The sidestream method is suitable for non-intubated or transported patients,but it is easy to be underestimated at high PaCO2,and it needs to be corrected regularly in combination with arterial blood gas.The clinical application should rationally choose monitoring method after a comprehensive assessment based on the patient's disease condition,oxygenation status,and the scenario of use.关键词
呼气末二氧化碳分压(PetCO2)/动脉血二氧化碳分压(PaCO2)/主流监测/旁流监测/临床应用评价Key words
Partial pressure of end tidal carbon dioxide(PetCO2)/Partial pressure of carbon dioxide(PaCO2)/Mainstream monitoring/Sidestream monitoring/Evaluation of clinical application分类
医药卫生引用本文复制引用
程胜,王飞,王国庆,王南海,朱德浩,刘志杰..主流与旁流呼气末二氧化碳分压监测技术的准确性及其临床评价研究[J].中国医学装备,2025,22(8):1-6,16,7.基金项目
中国医学装备协会应用评价分会课题项目(2024CAME014) Project of the Application Evaluation Branch of the Chinese Medical Equipment Association(2024CAME014) （2024CAME014）
