pulsioximetria y capnometria transcutanea
TRANSCRIPT
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Oximetría de pulso
& Capnometría
Transcutanea
IV Congreso Estatal de Pediatría.
La Paz, Baja California Sur.
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RELEVANCIA
EXACTITUD
Análisis Clínico
SIN invasión
O2 & CO2
DOLOR
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HAY OTRA HISTORIA QUE CONTAR
CAPNOMETRIA
Análisis Clínico
SIN invasión
Tecnología para monitoreo
al alcance,
uso practico
y con alta precisión
.
.
.
.
.
.
.
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
ERASE UNA VEZ ….
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100% del Personal de Salud han
usado un monitor.
TODOS hemos sido
sido monitoreados al menos
Una vez en la vida
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¿pero que es un Monitor?
¿ de donde viene «Monitor» ?
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Monitor, -oris
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SIGNOS VITALES
LABORATORIO
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HAY OTRA HISTORIA QUE CONTAR
CAPNOMETRIA
Análisis Clínico
SIN invasión
Tecnología para monitoreo
al alcance,
uso practico
y con alta precisión
.
.
.
.
.
.
.
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
ERASE UNA VEZ ….
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¿Cómo surgió la «pulsioximetria»?
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Takuo Aoyagi
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R/IR =
0.5 = 100% SpO2
1 = 82% SpO2
2 = 0% SpO2
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Ventajas oximetría de pulso vs.
Análisis de gases sanguíneos
-Menor costo
-No invasivo
-Continuo
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¿Cómo surgió la «Capnometría»?
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Primer sistema de análisis de gases sanguíneos
PO2 y PCO2
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Primer sistema de análisis de gases
sanguíneos medía PO2 + PCO2 +pH
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Sistema de análisis de PCO2 exhalados.
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HAY OTRA HISTORIA QUE CONTAR
CAPNOMETRIA
Análisis Clínico
SIN invasión
Tecnología para monitoreo
al alcance,
uso practico
y con alta precisión
.
.
.
.
.
.
.
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
ERASE UNA VEZ ….
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Ventilación Mecánica PICU.
Ventilación Espontanea & Ventilación no
invasiva.
Eventos respiratorios agudos.
Trans-quirurgicos
.
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Prueba de Apnea
Evaluación de la perfusión tisular
Monitoreo de equilibrio Acido-Base.
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Relación de HCO3 sérico que PtCO2
mientras mejora la acidosis.
Comparar cambios en PtCO2 & HCO3 durante
el tratamiento.
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TCM 3 monitor.
28 pacientes.
9.4 ± 4.7 años.
Comparar cambios en PtCO2 & HCO3 durante
el tratamiento.
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Se calculo el bicarbonato y uno sérico.
Diferencia Bica Real vs Calculado:
1.5 ± 1.2 mmol l.
Análisis de Regresión:
HCO3 = 0.61 ×(PtCO2 – 3.9)
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TOSCA Sys. Cable único CO2 + Sat O2.
Bebes pequeños 1.0 – 4.5 kg.- 60 px
Uso simple, calibración y lóbulo de oído.
Menos artefactos-Movimiento de cabeza-torax
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Sen-Tec, TOSCA 500, TINA TCM3
VS
CO2 arterial (PaCO2) & EtCO2
.
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Niños grandes 2-192 m. 18.5 m.
Grosor de piel Neo Vs Niño.
Coe Correlación muy buenos. No > 7.5 mmHg.
Precisión Bland/Altman ±11.5 ±10.6 ±14.8
Final- Los tres funcionan bien pero podría ser mejor.
Un poquito + SenTec
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No tan bueno en:
Hipotermia & Bajo Gasto & Inotrópicos.
Edema & Hipoperfusión.
Bueno en:
Enf. Pulmonar, Enf. Cardiaca Cianótico, No
intubados.
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Sen Tec
12 pacientes.
Objetivo:
Fiabilidad de la PtCO2 vs PaCO2.
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Sen Tec:
Correlación muy buena con PaCO2.
> 0.9 Con Coe Correlación Intraclase.
Bland-Altman infraestima PaCO2 0.9 mmHg
Sin relevancia clínica.
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