120: Comparison of transcutaneous oxygen tension (tcPO2) and arterial oxygen tension (PaO2) in newborn infants

Arterial oxygen tension measurements were performed simultaneously using two different techniques: (1) the conventional method of analyzing a blood sample obtained from the radial artery by means of a Clark electrode and (2) a new method of transcutaneous oxygen tension recording using a newly developed surface electrode containing a built-in heating device to ensure optimal cutaneous perfusion at the site of measurement. Two groups of newborn infants were used as subjects: (1) 70 clinically healthy babies who were tested during normoxia and hyperoxia (breathing 80% to 100% oxygen) and (2) 20 sick preterm and term infants receiving inspired oxygen concentrations of between 21% and 100% during the measurement. Our results indicate a satisfactory accuracy for the transcutaneous oxygen tension measurements in normoxia and hyperoxia (percentage coefficient of variation, 15.9% and 24.1%, respectively). In hypoxia agreement between the two methods varies depending on the degree of circulatory derangement. Overall correlation coefficients were greater than 0.85 in each group.

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Comparison of Transcutaneous Oxygen Tension With Arterial Oxygen Tension in Newborn Infants With Severe Respiratory Illnesses

PEDIATRICS ◽

10.1542/peds.62.5.692 ◽

1978 ◽

Vol 62 (5) ◽

pp. 692-697 ◽

Cited By ~ 1

Author(s):

Peter N. le Souëf ◽

Andrew K. Morgan ◽

Linda P. Soutter ◽

E. Osmund R. Reynolds ◽

Dawood Parker

Keyword(s):

Oxygen Tension ◽

Newborn Infants ◽

Arterial Oxygen Tension ◽

Oxygen Electrode ◽

Electrode Site ◽

Arterial Oxygen ◽

Transcutaneous Oxygen ◽

Skin Changes ◽

Respiratory Illnesses

Transcutaneous oxygen tesion (tcPO2), measured by two skin electrodes of different design, and arterial oxygen tension (PaO2), measured by an intravascular oxygen electrode, were continuously recorded for periods of six hours in 15 newborn infants with serious respiratory illnesses. Ten of the infants needed mechanical ventilation and three needed continuous positive airway pressure. One skin electrode had three microcathodes surrounded by a heated ring-shaped anode, and the other had a large heated cathode. The temperature of both electrodes was set at 44°C and they were calibrated in vitro. The tcPO2 recorded by the electrode with the microcathodes was found to estimate PaO2 reasonably accurately for the whole six-hour duration of the study. The tcPO2 recorded by the electrode with the large cathode gave a similar estimate of PaO2. for three hours, but then tcPO2. often fell relative to PaO2. This fall was probably caused by skin changes at the electrode site. For a variety of reasons, our results suggest that measurement of tcPO2. is unlikely to replace continuous intravascular measurement of PaO2. in infants with severe respiratory illnesses.

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Effect of Electrode Temperature and in Vivo Calibration on Accuracy of Transcutaneous Estimation of Arterial Oxygen Tension in Infants

PEDIATRICS ◽

10.1542/peds.65.3.515 ◽

1980 ◽

Vol 65 (3) ◽

pp. 515-522

Author(s):

Melanie J. Pollitzer ◽

Michelle D. Whitehead ◽

E. Osmund R. Reynolds ◽

David Delpy

Keyword(s):

Oxygen Tension ◽

Newborn Infants ◽

Arterial Oxygen Tension ◽

Oxygen Electrode ◽

Arterial Oxygen ◽

Optimal Temperature ◽

Transcutaneous Oxygen ◽

Skin Electrodes ◽

In Vivo Calibration

Previous studies showed that a skin oxygen electrode with a macrocathode, when heated to 43 C, underestimated arterial oxygen tension (Pao2). At 44 C the skin was damaged. The purpose of the present study was to assess the accuracy of the macrocathode electrode when set at 43.5 C. Transcutaneous oxygen tension (tcPo2) recorded by the macrocathode electrode at 43.5 C was compared with Pao2 measured continuously with an intravascular oxygen electrode, and with tcPo2 recorded by a microcathode electrode which has been shown earlier to work well at a temperature of 44 C. Both the skin electrodes were calibrated in vitro and in vivo. Particular attention was given to the details of calibration. Twelve newborn infants with respiratory illnesses were studied, each for six hours. Transcutaneous Po2 recorded by both skin electrodes was found to estimate Pao2 resonably accurately for the entire six-hour duration of the study, with the exception of a large and unexplained overestimation of Pao2 by the macrocathode electrode in one infant. This overestimation was corrected by in vivo calibration. Serious skin lesions were not seen after the skin electrodes were removed. We conclude that (1) The temperature setting of skin electrodes is crucial to their satisfactory performance. (2) For use on newborn infants, 43.5 C is the optimal temperature for the macrocathode electrode. (3) The optimal temperature for the microcathode electrode was confirmed as 44 C. (4) At these temperatures, both electrodes could be left on the same site on the skin for six hours. (5) Periodic in vivo calibration of skin electrodes is advisable.

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Continuous comparison of in vitro and in vivo-calibrated transcutaneous oxygen tension (tcPO2) with arterial oxygen tension (PaO2) in infants with respiratory illnesses

Pediatric Research ◽

10.1203/00006450-197901000-00072 ◽

1979 ◽

Vol 13 (1) ◽

pp. 81-81 ◽

Cited By ~ 1

Author(s):

M J Pollitzer ◽

A K Morgan ◽

E O R Reynolds ◽

L P Soutter ◽

D Parker

Keyword(s):

Oxygen Tension ◽

Arterial Oxygen Tension ◽

Arterial Oxygen ◽

Transcutaneous Oxygen Tension ◽

Transcutaneous Oxygen ◽

Respiratory Illnesses

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Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.00492.2018 ◽

2019 ◽

Vol 316 (5) ◽

pp. L705-L719 ◽

Cited By ~ 37

Author(s):

Martin Chaumont ◽

Philippe van de Borne ◽

Alfred Bernard ◽

Alain Van Muylem ◽

Guillaume Deprez ◽

...

Keyword(s):

Propylene Glycol ◽

Oxygen Tension ◽

Lung Inflammation ◽

Arterial Oxygen Tension ◽

Electronic Cigarette ◽

Arterial Oxygen ◽

Acute Effects ◽

Transcutaneous Oxygen Tension ◽

Transcutaneous Oxygen ◽

Heavy Smokers

When heated by an electronic cigarette, propylene glycol and glycerol produce a nicotine-carrying-aerosol. This hygroscopic/hyperosmolar aerosol can deposit deep within the lung. Whether these deposits trigger local inflammation and disturb pulmonary gas exchanges is not known. The aim of this study was to assess the acute effects of high-wattage electronic cigarette vaping with or without nicotine on lung inflammation biomarkers, transcutaneous gas tensions, and pulmonary function tests in young and healthy tobacco smokers. Acute effects of vaping without nicotine on arterial blood gas tensions were also assessed in heavy smokers suspected of coronary artery disease. Using a single-blind within-subjects study design, 25 young tobacco smokers underwent three experimental sessions in random order: sham-vaping and vaping with and without nicotine at 60 W. Twenty heavy smokers were also exposed to sham-vaping ( n = 10) or vaping without nicotine ( n = 10) in an open-label, randomized parallel study. In the young tobacco smokers, compared with sham-vaping: 1) serum club cell protein-16 increased after vaping without nicotine (mean ± SE, −0.5 ± 0.2 vs. +1.1 ± 0.3 µg/l, P = 0.013) and vaping with nicotine (+1.2 ± 0.3 µg/l, P = 0.009); 2) transcutaneous oxygen tension decreased for 60 min after vaping without nicotine (nadir, −0.3 ± 1 vs. −15.3 ± 2.3 mmHg, P < 0.001) and for 80-min after vaping with nicotine (nadir, −19.6 ± 2.8 mmHg, P < 0.001). Compared with sham vaping, vaping without nicotine decreased arterial oxygen tension for 5 min in heavy-smoking patients (+5.4 ± 3.3 vs. −5.4 ± 1.9 mmHg, P = 0.012). Acute vaping of propylene glycol/glycerol aerosol at high wattage with or without nicotine induces airway epithelial injury and sustained decrement in transcutaneous oxygen tension in young tobacco smokers. Intense vaping conditions also transiently impair arterial oxygen tension in heavy smokers.

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O2, Retrolental Fibroplasia Dogma Questioned

PEDIATRICS ◽

10.1542/peds.67.1.160a ◽

1981 ◽

Vol 67 (1) ◽

pp. 160-161

Author(s):

Avron Y. Sweet

Keyword(s):

Preterm Infant ◽

Oxygen Tension ◽

Bronchopulmonary Dysplasia ◽

Transcutaneous Oxygen Tension Measurements in Newborn Infants

PEDIATRICS ◽

10.1542/peds.55.2.232 ◽

1975 ◽

Vol 55 (2) ◽

pp. 232-235

Author(s):

Gosta Rooth

Keyword(s):

Continuous Monitoring ◽

Newborn Infants ◽

Arterial Oxygen ◽

Invasive Technique ◽

Clinical Experiences ◽

Transcutaneous Oxygen Tension ◽

Transcutaneous Oxygen ◽

Non Invasive ◽

Oxygen Tensions ◽

A New Technique

Attention is called in this brief review article to the development and clinical uses of a new technique for monitoring blood oxygen tensions in newborn infants. This technique uses an electrode recently developed by Huch et al. in Germany to measure arterial oxygen tensions directly through the skin. This device allows for continuous monitoring with a non-invasive technique. The method is now in use in European hospitals. Clinical experiences are cited to document its usefulness.

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Continuous Monitoring of Arterial Oxygen Tension Using a Catheter-Tip Polarographic Electrode in Infants

PEDIATRICS ◽

10.1542/peds.57.2.244 ◽

1976 ◽

Vol 57 (2) ◽

pp. 244-250

Author(s):

M. Conway ◽

G. M. Durbin ◽

D. Ingram ◽

N. McIntosh ◽

D. Parker ◽

...

Keyword(s):

Oxygen Tension ◽

Continuous Monitoring ◽

Newborn Infants ◽

Arterial Oxygen Tension ◽

Oxygen Electrode ◽

Arterial Oxygen ◽

Respiratory Illnesses ◽

Arterial Blood ◽

Reliable Instrument ◽

Catheter Tip

An oxygen electrode mounted in the tip of an umbilical artery catheter was used in 36 newborn infants with severe respiratory illnesses, 28 of whom survived. Thirty-seven electrodes were used. The median age at insertion was 4 hours (range, 30 minutes to 122 hours). Three electrodes failed to work and they were removed or replaced, and two could not be properly evaluated. Thirty-two electrodes functioned satisfactorily for 10 to 190 hours (mean, 75 hours) after a one-point calibration against blood sampled through the catheter. Twenty-two did not need recalibrating before they were removed after 10 to 190 hours (mean, 88 hours). Four of the remaining ten electrodes were recalibrated once after 33 to 97 hours and then functioned until removed 15 to 55 hours later. The other six electrodes failed after 32 to 105 hours (mean, 49 hours). Complications were few. A total of 356 arterial blood samples, obtained after the initial calibration and before any recalibration was necessary, gave a correlation coefficient of 0.93 (P < .0001) against an independent system for measuring arterial oxygen tension (Pao2) (Radiometer Type E.5046 oxygen electrode). We conclude that the catheter-tip electrode is a safe and reliable instrument for continuously recording Pao2 in newborn infants which much simplifies the management of serious respiratory illnesses.

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