多创伤和长期通气患者短期摄氧量测量的可靠性如何?

W Behrendt, M Surmann, J Raumanns, G Giani
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引用次数: 12

摘要

连续测量18例多发创伤患者和21例长期通气患者的o2摄取。所有患者均在充分镇静和镇痛的辅助下进行通气。每分钟测量一次o2吸收量,记录24 h内的o2吸收量,计算平均o2吸收量/min。同时,分别测定每小时最后15 min的o2吸收量(如7.45-8.00、8.45-9.00等)。将连续测量的平均o2摄取量/分钟与每天的平均o2摄取量进行比较,并将其与基于每次短期测量计算的平均o2摄取量相关联。两种方法的平均值只有微小的差异:在长期通气患者组中,连续测量的平均o2摄取为364 ml/min,短期测量的平均o2摄取为363 ml/min。这种臭氧的摄取相当于每天消耗2360千卡的能量。平均相关系数为0.89(范围:0.79 ~ 0.96)。如果在两个时间段(例如上午晚些时候和下午各15分钟)测量臭氧吸收量,则平均相关系数提高到0.94,标准差降低。在多重创伤患者组中获得了类似的结果。这项研究表明,在一定的前提条件下,短期测量2 × 15分钟的臭氧摄入量,可以充分可靠地预测严重创伤或危重病人每天的臭氧摄入量和能量消耗。
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How reliable are short-term measurements of oxygen uptake in polytraumatized and long-term ventilated patients?

O2-uptake was measured continuously in 18 polytraumatized and 21 long-term ventilated patients. All patients were on assisted ventilation with sufficient sedation and analgesia. O2-uptake was measured every minute, the values were recorded over 24 h and the mean O2-uptake/min was calculated. At the same time, the O2-uptake of the last 15 min of every hour was measured separately (e.g. 7.45-8.00, 8.45-9.00, etc.). The mean O2-uptake/min measured continuously was compared and correlated with the mean O2-uptake per day, calculated on the basis of each of the short-term measurements. There were only slight differences between the mean values of the two procedures: In the group of long-term ventilated patients the mean O2-uptake was found to be 364 ml/min in continuous measurements and 363 ml/min in short-term measurements. This O2-uptake corresponded to an energy expenditure of 2360 kcal/day. The mean correlation coefficient was 0.89 (range: 0.79-0.96). If O2-uptake was measured over 2 periods of 15 min each, e.g. in the late morning and in the afternoon, the mean correlation coefficient improved to 0.94 and the standard deviation was reduced. Comparable results were obtained in the group of polytraumatized patients. This study shows that under certain preconditions short-term measurements of O2-uptake of 2 x 15 min allow sufficiently reliable predictions of the daily O2-uptake and energy expenditure in severely traumatized or critically ill patients.

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