Login Register Cart 0
Generic placeholder image

Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Feasibility of Transcutaneous Method for Carbon Dioxide Monitoring in an Intensive Care Unit

Author(s): Nazlıhan Boyacı*, Sariyya Mammadova, Nurgül Naurizbay, Merve Güleryüz, Kamil İnci and Gül Gürsel

Volume 18, Issue 1, 2022

Published on: 31 January, 2022

Page: [29 - 33] Pages: 5

DOI: 10.2174/1573398X18666220103113003

Price: $65

Abstract

Background: Transcutaneous partial pressure of carbon dioxide (PtCO2) monitorization provides a continuous and non-invasive measurement of partial pressure of carbon dioxide (pCO2). In addition, peripheral oxygen saturation (SpO2) can also be measured and followed by this method. However, data regarding the correlation between PtCO2 and arterial pCO2 (PaCO2) measurements acquired from peripheric arterial blood gas is controversial.

Objective: We aimed to determine the reliability of PtCO2 with PaCO2 based on its advantages, like non-invasiveness and continuous applicability.

Methods: Thirty-five adult patients with hypercapnic respiratory failure admitted to our tertiary medical intensive care unit (ICU) were included. Then we compared PtCO2 and PaCO2 and both SpO2 measurements simultaneously. Thirty measurements from the deltoid zone and 26 measurements from the cheek zone were applied.

Results: PtCO2 could not be measured from the deltoid region in 5 (14%) patients. SpO2 and pulse rate could not be detected at 8 (26.7%) of the deltoid zone measurements. Correlation coefficients between PtCO2 and PaCO2 from deltoid and the cheek region were r: 0,915 and r: 0,946 (p = 0,0001). In comparison with the Bland-Altman test, difference in deltoid measurements was -1,38 ± 1,18 mmHg (p = 0.252) and in cheek measurements it was -5,12 ± 0,92 mmHg (p = 0,0001). There was no statistically significant difference between SpO2 measurements in each region.

Conclusion: Our results suggest that PtCO2 and SpO2 measurements from the deltoid region are reliable compared to the arterial blood gas analysis in hypercapnic ICU patients. More randomized controlled studies investigating the effects of different measurement areas, hemodynamic parameters, and hemoglobin levels are needed.

Keywords: Transcutaneous partial pressure of carbon dioxide, intensive care unit, critical care, carbon dioxide monitoring, partial arterial pressure of carbon dioxide, peripheral oxygen saturation.

« Previous Next »
Graphical Abstract

[1]
West JB. Causes of carbon dioxide retention in lung disease. N Engl J Med 1971; 284(22): 1232-6.
[http://dx.doi.org/10.1056/NEJM197106032842202] [PMID: 5573833]
[2]
Weinberger SE, Schwartzstein RM, Weiss JW. Hypercapnia. N Engl J Med 1989; 321(18): 1223-31.
[http://dx.doi.org/10.1056/NEJM198911023211804] [PMID: 2677729]
[3]
Yildizdaş D, Yapicioğlu H, Yilmaz HL, Sertdemir Y. Correlation of simultaneously obtained capillary, venous, and arterial blood gases of patients in a paediatric intensive care unit. Arch Dis Child 2004; 89(2): 176-80.
[http://dx.doi.org/10.1136/adc.2002.016261] [PMID: 14736638]
[4]
Adrogué HJ, Rashad MN, Gorin AB, Yacoub J, Madias NE. Assessing acid-base status in circulatory failure. Differences between arterial and central venous blood. N Engl J Med 1989; 320(20): 1312-6.
[http://dx.doi.org/10.1056/NEJM198905183202004] [PMID: 2535633]
[5]
Weil MH, Rackow EC, Trevino R, Grundler W, Falk JL, Griffel MI. Difference in acid-base state between venous and arterial blood during cardiopulmonary resuscitation. N Engl J Med 1986; 315(3): 153-6.
[http://dx.doi.org/10.1056/NEJM198607173150303] [PMID: 3088448]
[6]
Ruiz Y, Farrero E, Córdoba A, González N, Dorca J, Prats E. Transcutaneous carbon dioxide monitoring in subjects with acute respiratory failure and severe hypercapnia. Respir Care 2016; 61(4): 428-33.
[http://dx.doi.org/10.4187/respcare.04283] [PMID: 26786741]
[7]
Nicolini A, Ferrari MB. Evaluation of a transcutaneous carbon dioxide monitor in patients with acute respiratory failure. Ann Thorac Med 2011; 6(4): 217-20.
[http://dx.doi.org/10.4103/1817-1737.84776] [PMID: 21977067]
[8]
Stieglitz S, Matthes S, Priegnitz C, Hagmeyer L, Randerath W. Comparison of transcutaneous and capillary measurement of PCO2 in hypercapnic subjects. Respiratory Care 2016; 61(1): 98-105.
[http://dx.doi.org/10.4187/respcare.03917]
[9]
Spelten O, Fiedler F, Schier R, Wetsch WA, Hinkelbein J. Transcutaneous PTCCO2 measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients. J Clin Monit Comput 2017; 31(1): 153-8.
[http://dx.doi.org/10.1007/s10877-015-9810-8] [PMID: 26628269]
[10]
Huttmann SE, Windisch W, Storre JH. Techniques for the measurement and monitoring of carbon dioxide in the blood. Ann Am Thorac Soc 2014; 11(4): 645-52.
[http://dx.doi.org/10.1513/AnnalsATS.201311-387FR] [PMID: 24701974]
[11]
Senn O, Clarenbach CF, Kaplan V, Maggiorini M, Bloch KE. Monitoring carbon dioxide tension and arterial oxygen saturation by a single earlobe sensor in patients with critical illness or sleep apnea. Chest 2005; 128(3): 1291-6.
[http://dx.doi.org/10.1378/chest.128.3.1291] [PMID: 16162720]
[12]
Bolliger D, Steiner LA, Kasper J, Aziz OA, Filipovic M, Seeberger MD. The accuracy of non-invasive carbon dioxide monitoring: a clinical evaluation of two transcutaneous systems. Anaesthesia 2007; 62(4): 394-9.
[http://dx.doi.org/10.1111/j.1365-2044.2007.04987.x] [PMID: 17381578]
[13]
Delerme S, Montout V, Goulet H, et al. Concordance between transcutaneous and arterial measurements of carbon dioxide in an ED. Am J Emerg Med 2012; 30(9): 1872-6.
[http://dx.doi.org/10.1016/j.ajem.2012.03.033] [PMID: 22795407]
[14]
Bendjelid K, Schütz N, Stotz M, Gerard I, Suter PM, Romand JA. Transcutaneous PCO2 monitoring in critically ill adults: clinical evaluation of a new sensor. Crit Care Med 2005; 33(10): 2203-6.
[http://dx.doi.org/10.1097/01.CCM.0000181734.26070.26] [PMID: 16215371]
[15]
Kelly AM, Klim S. Agreement between arterial and transcutaneous PCO2 in patients undergoing non-invasive ventilation. Respir Med 2011; 105(2): 226-9.
[http://dx.doi.org/10.1016/j.rmed.2010.11.010] [PMID: 21131188]
[16]
Roediger R, Beck-Schimmer B, Theusinger OM, et al. The revised digital transcutaneous PCO2/SpO2 ear sensor is a reliable noninvasive monitoring tool in patients after cardiac surgery. J Cardiothorac Vasc Anesth 2011; 25(2): 243-9.
[http://dx.doi.org/10.1053/j.jvca.2010.06.021] [PMID: 20851636]

Rights & Permissions Print Cite
Article Metrics
25
1
© 2024 Bentham Science Publishers | Privacy Policy