Accuracy of Transcutaneous CO<sub>2</sub> Values Compared With Arterial and Capillary Blood Gases

Lambert, Laura L; Baldwin, Melissa B; Gonzalez, Cruz Velasco; Lowe, Gary; Willis, Jessika

doi:10.4187/respcare.05936

Cited by 21 publications

(16 citation statements)

References 10 publications

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“…Second, we did not compare tcpCO 2 values and those measured from blood samples in the present analyses of neonates without any intervention. Since there is controversial evidence in this regard (13)(14)(15), this aspect warrants further investigation.…”

Section: Discussionmentioning

confidence: 98%

Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study

et al. 2020

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Background: According to recommendations, non-invasive monitoring during neonatal resuscitation after birth includes heart rate (HR) and oxygen saturation (SpO 2). Continuous transcutaneous monitoring of carbon dioxide partial pressure (tcpCO 2) may further offer quantitative information on neonatal respiratory status. Objective: We aimed to investigate feasibility of tcpCO 2 measurements in the delivery room during immediate neonatal transition and to compare the course of tcpCO 2 between stable term and preterm infants. Methods: Neonates without need for cardio-respiratory intervention during immediate transition after birth were enrolled in a prospective observational study. In these term and preterm neonates, we measured HR and SpO 2 by pulse oximetry on the right wrist and tcpCO 2 with the sensor applied on the left hemithorax during the first 15 min after birth. Courses of tcpCO 2 were analyzed in term and preterm neonates and groups were compared. Results: Fifty-three term (gestational age: 38.8 ± 0.9 weeks) and 13 preterm neonates (gestational age: 34.1 ± 1.5 weeks) were included. First tcpCO 2 values were achieved in both groups at minute 4 after birth, which reached a stable plateau after the equilibration phase at minute 9. Mean tcpCO 2 values 15 min after birth were 46.2 (95% CI 34.5-57.8) mmHg in term neonates and 48.5 (95%CI 43.0-54.1) mmHg in preterm neonates. Preterm and term infants did not show significant differences in the tcpCO 2 values at any time point. Conclusion: This study demonstrates that tcpCO 2 measurement is feasible during immediate neonatal transition after birth and that tcpCO 2 values were comparable in stable term and preterm neonates.

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Section: Discussionmentioning

confidence: 98%

Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study

et al. 2020

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“…In a recent study, a sufficient number of ABG, CBG, and PtcCO 2 measurements were compared, and the authors reported that CBG comparisons showed less variation and a slightly lower correlation with PtcCO 2 than did ABG comparisons. 15 Although ETCO 2 was not considered in the study, findings supported the fact that arterial and PcCO 2 values could be measured by noninvasive methods. In our study, when a sufficient number of CBG and ETCO 2 measurements were compared, we found it possible to have an idea about PCO 2 levels with ETCO 2 , which is a noninvasive method.…”

Section: Discussionmentioning

confidence: 56%

Comparison of Simultaneous Capillary Blood Gases and End-Tidal Carbon Dioxide in Mechanically Ventilated Pediatric Patients with Acute Respiratory Failure

Konca

Tekin

Üçkardeş

et al. 2020

J Pediatr Intensive Care

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In the follow-up of ventilation, invasive blood gas analysis and noninvasive monitoring of end-tidal carbon dioxide (ETCO2) are used. We aimed to investigate the relationship between capillary partial pressure of carbon dioxide (PcCO2) levels and ETCO2 and also to investigate ETCO2's predictive feature of PcCO2 levels. This study included 28 female and 30 male pediatric patients; 28 patients were type-1 respiratory failure (RF), 16 patients were acute respiratory distress syndrome, and 14 patients were type-2 RF. Our results showed a significant correlation between ETCO2 and PcCO2. Although the strength of the correlation was weak throughout the measurements, the strength of this correlation increased significantly in type-2 RF.

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“…Since the transcutaneous PCO 2 measurement was approved for clinical use, the comparisons of TcPCO 2 with other methods had been examined [16,29,30]. The gold standard method to determine efficiency of gas exchange (V D /V T ) during an exercise test requires direct sampling of the arterial blood gases to determine PaCO 2 and application to the Bohr equation with Enghoff modification [6].…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous PCO₂ for Exercise Gas Exchange Efficiency in Chronic Obstructive Pulmonary Disease

Cao

Stringer

Corey

et al. 2021

COPD: Journal of Chronic Obstructive Pulmonary Disease

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Gas exchange inefficiency and dynamic hyperinflation contributes to exercise limitation in chronic obstructive pulmonary disease (COPD). It is also characterized by an elevated fraction of physiological dead space (V D /V T). Noninvasive methods for accurate V D /V T assessment during exercise in patients are lacking. The current study sought to compare transcutaneous PCO 2 (TcPCO 2) with the gold standard-arterial PCO 2 (PaCO 2)-and other available methods (end tidal CO 2 and the Jones equation) for estimating V D /V T during incremental exercise in COPD. Ten COPD patients completed a symptom limited incremental cycle exercise. TcPCO 2 was measured by a heated electrode on the ear-lobe. Radial artery blood was collected at rest, during unloaded cycling (UL) and every minute during exercise and recovery. Ventilation and gas exchange were measured breath-bybreath. Bland-Altman analysis examined agreement of PCO 2 and V D /V T calculated using PaCO 2 , TcPCO 2 , end-tidal PCO 2 (P ET CO 2) and estimated PaCO 2 by the Jones equation (PaCO 2-Jones). Lin's Concordance Correlation Coefficient (CCC) was assessed. 114 measurements were obtained from the 10 COPD subjects. The bias between TcPCO 2 and PaCO 2 was 0.86 mmHg with upper and lower limit of agreement ranging À2.28 mmHg to 3.99 mmHg. Correlation between TcPCO 2 and PaCO 2 during rest and exercise was r 2 ¼0.907 (p < 0.001; CCC ¼ 0.941) and V D /V T using TcPCO 2 vs. PaCO 2 was r 2 ¼0.958 (p < 0.0001; CCC ¼ 0.967). Correlation between PaCO 2-Jones and P ET CO 2 vs. PaCO 2 were r 2 ¼0.755, 0.755, (p < 0.001; CCC ¼ 0.832, 0.718) and for V D /V T calculation (r 2 ¼0.793, 0.610; p < 0.0001; CCC ¼ 0.760, 0.448), respectively. The results support the accuracy of TcPCO 2 to reflect PaCO 2 and calculate V D /V T during rest and exercise, but not in recovery, in COPD patients, enabling improved accuracy of noninvasive assessment of gas exchange inefficiency during incremental exercise testing.

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Accuracy of Transcutaneous CO₂ Values Compared With Arterial and Capillary Blood Gases

Cited by 21 publications

References 10 publications

Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study

Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study

Comparison of Simultaneous Capillary Blood Gases and End-Tidal Carbon Dioxide in Mechanically Ventilated Pediatric Patients with Acute Respiratory Failure

Transcutaneous PCO₂ for Exercise Gas Exchange Efficiency in Chronic Obstructive Pulmonary Disease

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Accuracy of Transcutaneous CO2 Values Compared With Arterial and Capillary Blood Gases

Cited by 21 publications

References 10 publications

Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study

Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study

Comparison of Simultaneous Capillary Blood Gases and End-Tidal Carbon Dioxide in Mechanically Ventilated Pediatric Patients with Acute Respiratory Failure

Transcutaneous PCO2 for Exercise Gas Exchange Efficiency in Chronic Obstructive Pulmonary Disease

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Product

Resources

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Accuracy of Transcutaneous CO₂ Values Compared With Arterial and Capillary Blood Gases

Transcutaneous PCO₂ for Exercise Gas Exchange Efficiency in Chronic Obstructive Pulmonary Disease