Transcutaneous PTCCO2 measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients.

Hyper or hypoventilation may have serious clinical consequences in critically ill patients and should be generally avoided, especially in neurosurgical patients. Therefore, monitoring of carbon dioxide partial pressure by intermittent arterial blood gas analysis (PaCO2) has become standard in intens...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 31; no. 1; pp. 153 - 159
Autores principales: Spelten, Oliver, Schier, Robert, Wetsch, Wolfgang, Hinkelbein, Jochen, Fiedler, Fritz, Wetsch, Wolfgang A
Formato: research tables/charts Journal Article
Publicado: Springer Nature Feb2017
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Transcutaneous PTCCO2 measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients.
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        au:
          Spelten, Oliver
          Schier, Robert
          Wetsch, Wolfgang
          Hinkelbein, Jochen
          Fiedler, Fritz
          Wetsch, Wolfgang A
        affil: Department of Anaesthesiology and Intensive Care Medicine , University Hospital of Cologne , Kerpener Str. 62 50931 Cologne Germany
      sug:
        subj:
          Blood Gas Analysis Methods
          Blood Gas Monitoring, Transcutaneous Methods
          Intensive Care Units
          Monitoring, Physiologic Methods
          Respiration, Artificial Methods
          Male
          Female
          Adult
          Sample Size
          Partial Pressure
          Critical Illness
          Aged
          Reproducibility of Results
          Carbon Dioxide Blood
          Critical Care
          Middle Age
          Time Factors
          Cost Benefit Analysis
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Hyper or hypoventilation may have serious clinical consequences in critically ill patients and should be generally avoided, especially in neurosurgical patients. Therefore, monitoring of carbon dioxide partial pressure by intermittent arterial blood gas analysis (PaCO2) has become standard in intensive care units (ICUs). However, several additional methods are available to determine PCO2 including end-tidal (PETCO2) and transcutaneous (PTCCO2) measurements. The aim of this study was to compare the accuracy and reliability of different methods to determine PCO2 in mechanically ventilated patients on ICU. After approval of the local ethics committee PCO2 was determined in n = 32 ICU consecutive patients requiring mechanical ventilation: (1) arterial PaCO2 blood gas analysis with Radiometer ABL 625 (ABL; gold standard), (2) arterial PaCO2 analysis with Immediate Response Mobile Analyzer (IRMA), (3) end-tidal PETCO2 by a Propaq 106 EL monitor and (4) transcutaneous PTCCO2 determination by a Tina TCM4. Bland-Altman method was used for statistical analysis; p < 0.05 was considered statistically significant. Statistical analysis revealed good correlation between PaCO2 by IRMA and ABL (R2 = 0.766; p < 0.01) as well as between PTCCO2 and ABL (R2 = 0.619; p < 0.01), whereas correlation between PETCO2 and ABL was weaker (R2 = 0.405; p < 0.01). Bland-Altman analysis revealed a bias and precision of 2.0 ± 3.7 mmHg for the IRMA, 2.2 ± 5.7 mmHg for transcutaneous, and -5.5 ± 5.6 mmHg for end-tidal measurement. Arterial CO2 partial pressure by IRMA (PaCO2) and PTCCO2 provided greater accuracy compared to the reference measurement (ABL) than the end-tidal CO2 measurements in critically ill in mechanically ventilated patients patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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