scholarly journals P123 Accuracy and Reliability of the Transcutaneous Carbon Dioxide (TcCO2) Signal in the Sleep Laboratory

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A61-A61
Author(s):  
A Rossely ◽  
A Turton ◽  
T Roebuck ◽  
S Ho ◽  
M Naughton ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Sleep Laboratory ◽  
Blood Gas ◽  
Sleep Study ◽  
Arterial Blood Gas ◽  
Transcutaneous Carbon Dioxide ◽  
Arterial Blood ◽  
Co2 Monitoring ◽  
Sleep Laboratories ◽  
Carbon Dioxide Co2

Abstract Carbon Dioxide (CO2) monitoring is an essential part of assessing and treating disorders of hypoventilation in the sleep laboratory. While reliablity issues have been previously reported with the Transcutaneous Carbon Dioxide (TcCO2) signal, there is limited data assessing the validity of this signal or its trend in the sleep laboratory context. Therefore, this study aimed to investigate the change in TcCO2 accuracy from the beginning to the end of the sleep study in real world conditions across two different Victorian public hospital sleep laboratories that used two different TcCO2 monitors. The sample included 13 consecutive patients from Monash Health and 44 consecutive patients from Alfred Health with an average age of 64 and 56 years respectively. Arterial Blood Gas (ABG) measurements were taken prior to and following each sleep study and compared concurrently with the TcCO2 value. Bland-Altman analysis revealed an average difference between TcCO2 and PaCO2 of 3.29mmHg with agreement between -11.44 and 16.64mmHg for the TCM4 device and 1.31mmHg with agreement between -7.64 and 9.05mmHg for the TCM5 device. When accuracy was compared across time points for each patient, 46% of patients had an overnight accuracy change of ≥ 8mmHg when using the TCM4 compared with 20% when using the TCM5. It was concluded that the TcCO2 signal was un-reliable across the different monitors and that the TcCO2 trend may be difficult to interpret with confidence without blood gas calibration at the commencement and conclusion of the sleep study.

scholarly journals Transcutaneous carbon dioxide measurement is not a reliable alternative to arterial blood gas sampling in the acute medical setting

2019 ◽  
Vol 53 (4) ◽  
pp. 1801726 ◽  
Author(s):  
Victoria Mummery ◽  
Eleanor Rogers ◽  
Vijay Padmanaban ◽  
Dionne Matthew ◽  
Thomas Woodcock ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Medical Setting ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Gas Sampling ◽  
Transcutaneous Carbon Dioxide ◽  
Arterial Blood ◽  
Carbon Dioxide Measurement

Validation of transcutaneous carbon dioxide monitoring using an artificial lung during adult pulsatile cardiopulmonary bypass

2021 ◽  
pp. 039139882098785
Author(s):  
Lawrence Garrison ◽  
Jeffrey B Riley ◽  
Steve Wysocki ◽  
Jennifer Souai ◽  
Hali Julick
Keyword(s):  
Carbon Dioxide ◽  
Cardiopulmonary Bypass ◽  
Gold Standard ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Artificial Lung ◽  
Blood Gas ◽  
Median Difference ◽  
Transcutaneous Carbon Dioxide ◽  
Arterial Blood

Measurements of transcutaneous carbon dioxide (tcCO2) have been used in multiple venues, such as during procedures utilizing jet ventilation, hyperbaric oxygen therapy, as well as both the adult and neo-natal ICUs. However, tcCO2 measurements have not been validated under conditions which utilize an artificial lung, such cardiopulmonary bypass (CPB). The purpose of this study was to (1) validate the use of tcCO2 using an artificial lung during CPB and (2) identify a location for the sensor that would optimize estimation of PaCO2 when compared to the gold standard of blood gas analysis. tcCO2 measurements ( N = 185) were collected every 30 min during 54 pulsatile CPB procedures. The agreement/differences between the tcCO2 and the PaCO2 were compared by three sensor locations. Compared to the earlobe or the forehead, the submandibular PtcCO2 values agreed best with the PaCO2 and with a median difference of –.03 mmHg (IQR = 5.4, p < 0.001). The small median difference and acceptable IQR support the validity of the tcCO2 measurement. The multiple linear regression model for predicting the agreement between the submandibular tcCO2 and PaCO2 included the SvO2, the oxygenator gas to blood flow ratio, and the native perfusion index ( R2 = 0.699, df = 1, 60; F = 19.1, p < 0.001). Our experience in utilizing tcCO2 during CPB has demonstrated accuracy in estimating PaCO2 when compared to the gold standard arterial blood gas analysis, even during CO2 flooding of the surgical field.

Feasıbılıty of Transcutaneous Method for Carbon Dıoxıde Monıtorıng in an Intensive Care Unıt

2022 ◽  
Vol 18 ◽  
Author(s):  
Nazlıhan Boyacı ◽  
Sariyya Mammadova ◽  
Nurgül Naurizbay ◽  
Merve Güleryüz ◽  
Kamil İnci ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Partial Pressure ◽  
Blood Gas ◽  
Peripheral Oxygen Saturation ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Randomized Controlled Studies ◽  
Significant Difference

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.

Concordance Between Capnography and Arterial Blood Gas Measurements of Carbon Dioxide in Acute Asthma

2005 ◽  
Vol 46 (4) ◽  
pp. 323-327 ◽  
Author(s):  
Jill Corbo ◽  
Polly Bijur ◽  
Michael Lahn ◽  
E. John Gallagher
Keyword(s):  
Carbon Dioxide ◽  
Acute Asthma ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Gas Measurements
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