Pediyatrik Kalp Cerrahisinde Transkutanöz ve İntraarteriyel Kan Gazı Monitörizasyonun Karşılaştırılması
Abstract
Amaç: Çalışmada pediyatrik kalp cerrahisi geçiren hastalarda trankutanöz ve intraarteriyel kan gazı ölçümleri karşılaştırıldı.
Gereç ve Yöntemler: Haziran 2014 – Kasım 2015 yılları arasında konjenital kalp hastalıkları nedeniyle opere edilen toplam
150 pediyatrik hasta çalışmaya dahil edildi. Pediyatrik kalp cerrahisi geçiren pediyatrik hastalarda oksijen ve karbondioksit
basınçlarını ölçmek için transkutanöz non-invazif cihazın etkinliği değerlendirildi. Yüz elli pediyatrik hastada eşzamanlı
transkutanöz ve konvansiyonel arteryel kan gazlarında parsiyel oksijen ve karbondioksit basınç değerleri ölçüldü.
Bulgular: Opere edilen hastaların ortalama yaş ve kiloları sırasıyla 3.7±3.1 yıl (1 ay – 16 yaş) ve 11.7±15.1 kg (3.5 – 55
kg) aralığındaydı. Ölçülen parsiyel oksijen ve karbondioksit basınç değerleri ortalama farkları sırasıyla 8 mmHg (dağılım,
3 - 20 mmHg), 12 mmHg (dağılım, 7 - 25 mmHg)’di (p<0.05). Bu farklar istatistiksel olarak farklı olmakla birlikte sadece
inotropik skoru 20’nin altında olan hastalar değerlendirildiğinde bu fark istatistiksel olarak anlamlı değildi (p>0.05). Bunun
nedeni olarak da deri perfüzyonuna bağlı transkutanöz ölçümler nispeten normal kardiyovasküler fonksiyon gibi optimal
şartlarda daha doğru ve güvenilir sonuçlar vermesi olarak gözlendi.
Sonuç: Transkutanöz ölçümlerin doğruluğunun invazif metottan daha az olmasına rağmen optimal şartların sağlanabildiği
yoğun bakım ünitelerinde kullanımı invazif arteryel girişim sayısını ve kan ile teması azaltması yanında devamlı
monitörizasyon ile ventilasyon etkinliği değerlendirme olanağı sunmaktadır.
References
- 1. Takiwaki H, Nakanishi H, Shono Y, Arase S. The influence of cutaneous factors on the transcutaneous pO2 and pCO2 at various body sites. Br J Dermatol 1991;125:243–7.
- 2. Nishiyama T, Nakamura S, Yamashita K. Effects of the electrode temperature of a new monitor, TCM4, on the measurement of transcutaneous oxygen and carbon dioxide tension. J Anesth 2006;20:331-4.
- 3. Nosovitch MA, Johnson JO, Tobias JD. Noninvasive intraoperative monitoring of carbon dioxide in children: Endtidal versus transcutaneous techniques. Paediatr Anaesth 2002;12:48–52.
- 4. Wilson J, Russo P, Russo J, Tobias JD. Noninvasive monitoring of carbon dioxide in infants and children with congenital heart disease: End-tidal versus transcutaneous techniques. J Intensive Care Med 2005;20:291–5.
- 5. Shore S, Nelson D, Pearl J, Manning P, Wong H, Shanley T, et al. Usefulness of corticosteroid therapy in decreasing epinephrine requirements in critically ill infants with congenital heart disease. Am J Cardiol 2001;88:591–4.
- 6. Janssens JP, Perrin E, Bennani I, de Muralt B, Titelion V, Picaud C. Is continuous transcutaneous monitoring of PCO2 (TcPCO2) over 8 h reliable in adults? Respir Med 2001;95:331–5.
- 7. Pilsbury D, Hibbert G. An ambulatory system for long-term continuous monitoring of transcutaneous PCO2. Bull Eur Physiopathol Respir 1987;23:9–13.
- 8. Herrell N, Martin RJ, Pultusker M, Lough M, Fanaroff A. Optimal temperature for the measurement of transcutaneous carbondioxide tension in the neonate. J Pediatr 1980;97:114–7.
- 9. Dawson S, Cave C, Pavord I, Potter CF. Transcutaneous monitoring of blood gases: Is it comparable with arterialized earlobe sampling? Respiratory medicine 1998;92:584-7.
- 10. Berardesa E, Maibach H. Transcutaneous CO2 and O2 diffusion. Skin Pharmacology 1993;6:3-9.
- 11. Franklin ML. Transcutaneous measurement of partial pressure of oxygen and carbon dioxide. Respir Care Clin N Am 1995;1:119- 31.
- 12. Sorensen LC, Brage-Andersen L, Greisen G. Effects of the transcutaneous electrode temperature on the accuracy of transcutaneous carbon dioxide tension. Scandinavian Journal of Clinical and Laboratory Investigation 2011;71:548–52.
- 13. Toffaletti JG, Rackley CR. Monitoring oxygen status. Adv Clin Chem 2016;77:103-24.
Abstract
References
- 1. Takiwaki H, Nakanishi H, Shono Y, Arase S. The influence of cutaneous factors on the transcutaneous pO2 and pCO2 at various body sites. Br J Dermatol 1991;125:243–7.
- 2. Nishiyama T, Nakamura S, Yamashita K. Effects of the electrode temperature of a new monitor, TCM4, on the measurement of transcutaneous oxygen and carbon dioxide tension. J Anesth 2006;20:331-4.
- 3. Nosovitch MA, Johnson JO, Tobias JD. Noninvasive intraoperative monitoring of carbon dioxide in children: Endtidal versus transcutaneous techniques. Paediatr Anaesth 2002;12:48–52.
- 4. Wilson J, Russo P, Russo J, Tobias JD. Noninvasive monitoring of carbon dioxide in infants and children with congenital heart disease: End-tidal versus transcutaneous techniques. J Intensive Care Med 2005;20:291–5.
- 5. Shore S, Nelson D, Pearl J, Manning P, Wong H, Shanley T, et al. Usefulness of corticosteroid therapy in decreasing epinephrine requirements in critically ill infants with congenital heart disease. Am J Cardiol 2001;88:591–4.
- 6. Janssens JP, Perrin E, Bennani I, de Muralt B, Titelion V, Picaud C. Is continuous transcutaneous monitoring of PCO2 (TcPCO2) over 8 h reliable in adults? Respir Med 2001;95:331–5.
- 7. Pilsbury D, Hibbert G. An ambulatory system for long-term continuous monitoring of transcutaneous PCO2. Bull Eur Physiopathol Respir 1987;23:9–13.
- 8. Herrell N, Martin RJ, Pultusker M, Lough M, Fanaroff A. Optimal temperature for the measurement of transcutaneous carbondioxide tension in the neonate. J Pediatr 1980;97:114–7.
- 9. Dawson S, Cave C, Pavord I, Potter CF. Transcutaneous monitoring of blood gases: Is it comparable with arterialized earlobe sampling? Respiratory medicine 1998;92:584-7.
- 10. Berardesa E, Maibach H. Transcutaneous CO2 and O2 diffusion. Skin Pharmacology 1993;6:3-9.
- 11. Franklin ML. Transcutaneous measurement of partial pressure of oxygen and carbon dioxide. Respir Care Clin N Am 1995;1:119- 31.
- 12. Sorensen LC, Brage-Andersen L, Greisen G. Effects of the transcutaneous electrode temperature on the accuracy of transcutaneous carbon dioxide tension. Scandinavian Journal of Clinical and Laboratory Investigation 2011;71:548–52.
- 13. Toffaletti JG, Rackley CR. Monitoring oxygen status. Adv Clin Chem 2016;77:103-24.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | December 30, 2018 |
| Submission Date | September 24, 2017 |
| Published in Issue | Year 2018 Volume: 12 Issue: 4 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.