摘要：目的检查2003年严重脑外伤儿科指南出版后此类患儿发生严重低碳酸血症（SH）的情况。设计回顾性队列研究。场所华盛顿州西雅图Harborview医学中心（1995年1月1日至2005年12月31日）。对象〈15岁的严重脑外伤患儿。干预无。主要结果指南前组（2003年8月1日前）共375例患儿，指南后组共89例患儿。与指南前组比较，指南后组在患儿入院48h内倾向于更早（45min vs 32min，P=0．05）及更频繁地采血测PaCO2（7．1次 vs 8．4次，P=0．06）。0～2岁患儿入院至采第一份血样的时间较年长儿迟（75．0 min vs 44．3 min）。最年幼的患儿首次血样发现SH的机率也最高（31％ vs 19％，P=0．02）。指南出版后SH的发病率仍居高不下（60％vs 52％，P=0．20）。但在11年间，发生SH的优势比明显下降（校正OR值为0．9，95％CI：0．84～0．96）。指南发表前后，患儿入院最初2h的SH的发病率均最高。指南发表后颅内压（ICP）监测更普遍。82例行ICP监测的SH患儿中，62例（77％）最早期的ICP〈20mmHg（1mmHg=0．133kPa）。SH与住院患儿的病死率独立相关（校正OR值为2．8；95％CI：1．30～5．90）。结论虽然指南发表后pacch的采样频率增加，而且SH的发生连年下降，但入院最初48h的SH的发病率仍较高。年幼儿入院至首次采样测PaCO2的时间较迟，与SH发病率高有关。SH可用于预测患儿病死率。

摘要：The European Directive 2010/31 claims that by 2020 only (nearly-) ZEB (zero-energy-buildings) may be built. To reach this goal, it is pertinent for buildings to be energetically optimized first. The remaining energy demand must then be covered by on-site renewable energies (PV, geothermal, etc.). With the area of use (energy demand) and the size of the building envelope/estate (renewable energy supply) in competition with each other, the maximum number of building stories will be most likely limited. For 15 different climatic locations worldwide, the energy demand of optimised office rooms has been simulated and compared with the possible renewable energy production on site. For every location, a good correlation has been found between the simulated energy demand and data like heating and cooling degree hours. Correspondent linear equations are given here. As another result, the maximum numbers of possible stories for ZEBS have been derived, being between 3 and 10 depending on the location.