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TcPO2 changes are more pronounced than SpO2 changes during simulated altitude changes in a hypobaric oxygen chamber: a nonrandomized controlled trial 在低压氧舱中模拟海拔高度变化时,TcPO2 的变化比 SpO2 的变化更明显:一项非随机对照试验
Pub Date : 2024-06-06 DOI: 10.1097/ec9.0000000000000122
Yang Li, Liang Chen, Ziyu Fu, Zhiwei Wang, Shijun Sun, Xiaorong Luan, Dedong Ma, Tianliang Hu
Hypoxia is a significant risk factor of hypertension. However, no studies have used transcutaneous tissue partial pressure of oxygen (TcPO2) and partial pressure of carbon dioxide (TcPCO2) monitors to measure the respective partial pressures in healthy individuals. Oxygen saturation (SpO2) is often used for traditional monitoring of vital signs. This study investigated the changes in TcPO2 and SpO2 values during rapid changes in altitude. The trial was registered at ClinicalTrials.gov (registration no. NCT06076057). Healthy adult volunteers were instructed to sit vertically in a hypobaric oxygen chamber, which ascended from 0 m to 2500 m at a uniform speed within 10 min. The Danish Radiometer TCM4 was used to measure TcPO2 and TcPCO2 with the ventral side of the upper arm as the measurement site. The Shenzhen Kerokan P0D-1 W pulse oximeter was used to measure heart rate and SpO2, with values recorded once every 500 m. Altogether, 49 healthy volunteers were recruited between March 2023 and August 2023. With increasing altitude, TcPO2 and SpO2 decreased significantly (P < 0.01). During the ascent from 0 m, TcPO2 began to change statistically at 500 m (P < 0.05), whereas SpO2 began to change statistically at 1000 m (P < 0.05). At the same altitude, the difference in TcPO2 was greater than the difference in SpO2. At 1000 m, there were statistically significant changes in TcPO2 and SpO2 (P < 0.001). At altitudes >500 m, statistical significance was identified between TcPO2 in both sexes (P < 0.05). Statistical significance in TcPCO2 and heart rate was observed at the different elevations (P < 0.05). In acutely changing low-pressure hypoxic environments, TcPO2 changed more dramatically than SpO2.
缺氧是高血压的一个重要风险因素。然而,还没有研究使用经皮组织氧分压(TcPO2)和二氧化碳分压(TcPCO2)监测仪来测量健康人各自的氧分压。传统的生命体征监测通常使用血氧饱和度(SpO2)。本研究调查了海拔快速变化时 TcPO2 和 SpO2 值的变化。该试验已在 ClinicalTrials.gov 网站注册(注册号:NCT06076057)。 健康的成年志愿者被要求垂直坐在低压氧舱中,氧舱在 10 分钟内从 0 米匀速上升到 2500 米。使用丹麦 Radiometer TCM4 测量 TcPO2 和 TcPCO2,测量部位为上臂腹侧。2023 年 3 月至 2023 年 8 月期间,共招募了 49 名健康志愿者。随着海拔的升高,TcPO2 和 SpO2 显著下降(P < 0.01)。在从 0 米上升的过程中,TcPO2 在 500 米处开始发生统计学变化(P < 0.05),而 SpO2 在 1000 米处开始发生统计学变化(P < 0.05)。在同一高度,TcPO2 的差异大于 SpO2 的差异。海拔 1000 米时,TcPO2 和 SpO2 的变化具有统计学意义(P < 0.001)。在海拔高度大于 500 米时,男女 TcPO2 之间有统计学意义(P < 0.05)。在不同的海拔高度,TcPCO2 和心率之间存在统计学意义(P < 0.05)。 在急剧变化的低压缺氧环境中,TcPO2 的变化比 SpO2 更大。
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引用次数: 0
Serum amylase as a novel prognostic marker of organophosphorus poisoning: a retrospective study 血清淀粉酶作为有机磷中毒的新型预后指标:一项回顾性研究
Pub Date : 2024-06-03 DOI: 10.1097/ec9.0000000000000110
Xinxin Guo, Zhongwei Chen, Ke Feng, Siyao Zeng, Junfei Zhang, Zhe Ma, Changda Yuan
This study aims to explore the significance of serum amylase levels in patients with organophosphorus pesticide (OP) poisoning and to provide a new perspective for evaluating the severity and prognosis of OP poisoning. The clinical data of 67 patients with acute OP poisoning, who had been treated in the emergency department of the General Hospital of Ningxia Medical University between September 2020 and August 2022, were retrospectively analyzed. Using Spearman rank correlation, serum amylase levels during admission and severity of poisoning correlated with discharge outcomes. Based on serum amylase levels, receiver operating characteristic curves were plotted to predict the severity and mortality of patients who experience organophosphate poisoning. The optimal threshold serum amylase level at admission was determined based on the maximum Youden index. Using Spearman rank correlation analysis, serum amylase levels at admission positively correlated with the severity of poisoning and discharge outcomes, but the degree of correlation was weak (r s: 0.344; 0.264; P < 0.05). The patients’ serum amylase levels at admission had receiver operating characteristic area under the curve values of 0.726 and 0.735 to predict the degree of severe poisoning and death, respectively. Based on the maximum Youden index, the optimal threshold of serum amylase were 97.8 and 194.1 U/L when the degree of poisoning was severe and the discharge outcome of patients was died. In comparison to patients with serum amylase levels ≤194.1 U/L at admission, the OR values of death in patients with serum amylase levels >194.1 U/L at admission was 15.944 (95% CI: 1.825–139.274). Serum amylase levels in patients with organophosphate poisoning correlate with the degree of poisoning and discharge outcomes. Higher serum amylase level was a risk factor for organophosphorus poisoning death.
本研究旨在探讨血清淀粉酶水平在有机磷农药(OP)中毒患者中的意义,为评估OP中毒的严重程度和预后提供新的视角。 该研究对宁夏医科大学总医院急诊科 2020 年 9 月至 2022 年 8 月间收治的 67 例急性 OP 中毒患者的临床资料进行了回顾性分析。通过斯皮尔曼秩相关分析,入院时血清淀粉酶水平和中毒严重程度与出院结果相关。根据血清淀粉酶水平,绘制了接收者操作特征曲线,以预测有机磷中毒患者的严重程度和死亡率。根据最大尤登指数确定了入院时血清淀粉酶水平的最佳阈值。 通过斯皮尔曼秩相关分析,入院时的血清淀粉酶水平与中毒严重程度和出院结果呈正相关,但相关程度较弱(r s: 0.344; 0.264; P < 0.05)。入院时患者血清淀粉酶水平的曲线下接收操作特征面积值分别为 0.726 和 0.735,可预测严重中毒和死亡程度。根据最大尤登指数(Youden index),当中毒程度为重度且出院结果为死亡时,血清淀粉酶的最佳临界值分别为 97.8 和 194.1 U/L。与入院时血清淀粉酶水平≤194.1 U/L的患者相比,入院时血清淀粉酶水平>194.1 U/L的患者的死亡OR值为15.944(95% CI:1.825-139.274)。 有机磷中毒患者的血清淀粉酶水平与中毒程度和出院结果相关。较高的血清淀粉酶水平是有机磷中毒死亡的一个危险因素。
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Emergency and Critical Care Medicine
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