A new oxygenation index for reflecting intrapulmonary shunting in patients undergoing open-heart surgery

被引：41

作者：

El-Khatib, MF

Jamaleddine, GW

机构：

[1] Amer Univ Beirut, Sch Med, Dept Anesthesiol, Beirut 11072020, Lebanon

[2] Amer Univ Beirut, Sch Med, Dept Med, Beirut 11072020, Lebanon

来源：

CHEST | 2004年 / 125卷 / 02期

关键词：

intrapulmonary shunt; mean airway pressure; open-heart surgery; oxygenation factor; oxygenation measurements; oxygenation ratio; positive end-expiratory pressure;

D O I：

10.1378/chest.125.2.592

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objectives: To assess the reliability of new and traditional oxygenation measurements in reflecting intrapulmonary shunt. Design: Prospective study. Setting: Cardiac surgery unit at a university hospital. Patients: Fifty-five patients undergoing coronary artery bypass grafting. Measurements and results: Simultaneous blood samples were collected from an indwelling arterial line and a catheter for determination of blood gases. Standard accepted formulas were utilized to measure a new oxygenation index:, PaO2/fraction of inspired oxygen (FIO2) X mean airway pressure (P (aw) over bar). The standard formulas used were the oxygenation ratio (PaO2/FIO2), PaO2/alveolar partial oxygen pressure (PAO(2)), alveolar-arterial oxygen tension gradient (P[A-a]O-2), and intrapulmonary shunt (venous admixture [Qsp/Qt]). There were significant negative (p < 0.05) correlations between the PaO2/(FIO2 x P (aw) over bar) and Qsp/Qt (r = -0.85), between the PaO2/FIO2 and Qsp/Qt (r = -0.74), and between the PaO2/PAO(2) and Qsp/Qt (r = -0.71). There was a significant positive (p < 0.05) correlation between the P(A-a)O-2 gradient and Qsp/Qt (r = 0.66). However, the correlation was strongest between the PaO2/(FIO2 x P (aw) over bar) and Qsp/Qt. Conclusion; In this group of patients, PaO2/(FIO2 x P (aw) over bar) might be more reliable than other oxygenation measurements in reflecting intrapulmonary shunt.

引用

页码：592 / 596

页数：5

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