Accuracy and clinical performance of a continuous intra-arterial blood-gas monitoring system during thoracoscopic surgery

Abstract

SummaryAccuracy and performance of the only currently available intra-arterial blood-gas monitoring system (Paratrend 7, PT7) were assessed in 23 patients during thoracoscopic surgery using onelung ventilation. Over a wide range of values for arterial PO 2 (6.1-61.1 kPa), PCO 2 (4.1-9.5 kPa) and pH (7.19-7.50), 138 arterial blood-gas values obtained by PT7 were compared with corresponding in vitro laboratory blood-gas measurements. We found good clinical performance with the PT7 and good agreement between PT7 values and in vitro measurements for arterial PO 2 (bias (1.96 SD):0.38 (9.52) kPa), PCO 2 (0.31 (0.76) kPa) and pH (90.017 (0.065)). Also, the bias for sequential changes between two consecutive times was not significantly different from the ideal value of 0. We conclude that the PT7 is helpful in monitoring patients during thoracoscopy. (Br.

Continuous Monitoring of Fetal pH, pO₂ and pCO₂ Using a Fiberoptic Multiparameter Sensor in Animal Models Reproducing in utero Conditions

“…Furthermore, this method provides continuous measurements that can easily be stored and enhances the early detection of minimal changes and trend analysis. This technique has been tested successfully in neonatal, pediatric, and adult intensive care and surgery [7][8][9][10][11]. To the best of our knowledge, this is the first report on the feasibility and accuracy of fiberoptic multiparameter sensing in fetal monitoring.…”

“…Fiberoptic sensors are now commercially available including the Neotrend ® multiparameter intravascular sensor (MPIS) used in this study. It provides continuous measurements of pO 2 , pCO 2 , pH, and temperature and has been successfully used in both adult and neonatal intensive care situations [7,8]. Validation of the accuracy of this sensor has been demonstrated in vivo in the physiologic range for postnatal values [5,[9][10][11] but never focussed on the low range of pO 2 present in fetal life.…”

Continuous intra-arterial blood gas monitoring during thoracic surgery

“…To the best of our knowledge, there has been only one other institution that has investigated the accuracy and clinical performance of PT7 during OLV [7,8]. Zollinger et al evaluated the accuracy of the CIABG monitor during thoracoscopic surgery in patients undergoing OLV and reported the bias and the precision (1.96 SD) for Po 2 in their study to be 0.38 Ϯ 9.52 torr [7].…”

“…Zollinger et al evaluated the accuracy of the CIABG monitor during thoracoscopic surgery in patients undergoing OLV and reported the bias and the precision (1.96 SD) for Po 2 in their study to be 0.38 Ϯ 9.52 torr [7]. The precision for Po 2 in their study was smaller than that for the thoracoscopy group in the present study, and the discrepancy may be attributed, in part, to the timing of the data collection: Zollinger et al included data that were collected when OLV was not performed.…”

How often should we perform arterial blood gas analysis during thoracoscopic surgery?

“…One-lung ventilation (OLV) during thoracoscopic surgery may be associated with rapid and unexpected changes in arterial blood gas (ABG) values [1][2][3][4]. Intermittent ABG analyses are essential to assess blood gas status during thoracoscopic surgery because noninvasive techniques such as pulse oximetry [5][6][7], capnometry [8,9], and transcutaneous blood gas measurements [10,11] have major limitations and frequently fail to monitor the extreme blood gas changes observed during OLV.…”