Combined Oximetry-Cutaneous Capnography in Patients Assessed for Long-term Oxygen Therapy

Török, Salome Schafroth; Leüppi, Jörg D.; Baty, Florent; Tamm, Michael; Chhajed, Prashant N.

doi:10.1378/chest.07-0960

Cited by 17 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In ventilated patients, PaCO 2 measured by arterial puncture may not provide an accurate picture of the overnight time course of PaCO 2 [ 19 , 22 ]. Several studies have shown that continuous TcPCO 2 recording is well correlated with arterial measurements in chronic respiratory failure under NIV [ 10 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Monitoring of noninvasive ventilation: comparative analysis of different strategies

et al. 2020

View full text Add to dashboard Cite

Background Noninvasive ventilation (NIV) represents an effective treatment for chronic respiratory failure. However, empirically determined NIV settings may not achieve optimal ventilatory support. Therefore, the efficacy of NIV should be systematically monitored. The minimal recommended monitoring strategy includes clinical assessment, arterial blood gases (ABG) and nocturnal transcutaneous pulsed oxygen saturation (SpO2). Polysomnography is a theoretical gold standard but is not routinely available in many centers. Simple tools such as transcutaneous capnography (TcPCO2) or ventilator built-in software provide reliable informations but their role in NIV monitoring has yet to be defined. The aim of our work was to compare the accuracy of different combinations of tests to assess NIV efficacy. Methods This retrospective comparative study evaluated the efficacy of NIV in consecutive patients through four strategies (A, B, C and D) using four different tools in various combinations. These tools included morning ABG, nocturnal SpO2, TcPCO2 and data provided by built-in software via a dedicated module. Strategy A (ABG + nocturnal SpO2), B (nocturnal SpO2 + TcPCO2) and C (TcPCO2 + builtin software) were compared to strategy D, which combined all four tools (NIV was appropriate if all four tools were normal). Results NIV was appropriate in only 29 of the 100 included patients. Strategy A considered 53 patients as appropriately ventilated. Strategy B considered 48 patients as appropriately ventilated. Strategy C misclassified only 6 patients with daytime hypercapnia. Conclusion Monitoring ABG and nocturnal SpO2 is not enough to assess NIV efficacy. Combining data from ventilator built-in software and TcPCO2 seems to represent the best strategy to detect poor NIV efficacy. Trialregistration Institutional Review Board of the Société de Pneumologie de Langue Française (CEPRO 2016 Georges)

show abstract

Section: Discussionmentioning

confidence: 99%

Monitoring of noninvasive ventilation: comparative analysis of different strategies

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Transcutaneous measurement of carbon dioxide (PtCO 2 ) offers constant monitoring of CO 2 and is a pain-free alternative to arterial blood gas analysis [1], which has more potential side effects (bleeding, haematoma, thrombosis [2]) and results in only a snapshot compared with continuous monitoring. In a number of studies, PtCO 2 monitoring has been shown to be a reliable alternative to measurement of arterial carbon dioxide tension (PaCO 2 ) [3][4][5][6][7][8][9][10][11][12][13]. This was also demonstrated in hypotensive patients (mean arterial pressure <60 mm Hg) [14].…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous versus blood carbon dioxide monitoring during acute noninvasive ventilation in the emergency department – a retrospective analysis

Horvath¹,

Brutsche²,

Baty³

et al. 2016

Swiss Med Wkly

View full text Add to dashboard Cite

Transcutaneous PCO2 monitoring shows a good concordance with PaCO2 and is a reliable, feasible, patient-friendly and safe alternative to repeated blood gas analysis for patients with severe hypoxaemic and/or hypercapnic respiratory failure receiving emergency NIV in the emergency department. An initial blood gas analysis to evaluate the respiratory and metabolic state and to rule out a significant discrepancy compared with the transcutaneous measurement is recommended.

show abstract

“…Cooper et al reported a mean PaO 2 increase of 3 kPa, and a mean PaCO 2 increase of 0.39 kPa, while patients were breathing oxygen (30% concentration) [ 53 ]. Török et al showed increase in PaCO 2 during incremental increase of oxygen flow in the initial adjustment of LTOT but the “rise in CO 2 was not considered to be high enough to lead to a lower prescription of oxygen” [ 54 ]. During sleep, however, physiological changes occur that cause the SpO 2 to drop for the patients with COPD (nocturnal oxygen desaturation (NOD)).…”

Section: Chronic Obstructive Pulmonary Disease—a Short Description Fomentioning

confidence: 99%

Continuous remote monitoring of COPD patients—justification and explanation of the requirements and a survey of the available technologies

Tomašić

Trobec

et al. 2018

Med Biol Eng Comput

View full text Add to dashboard Cite

Remote patient monitoring should reduce mortality rates, improve care, and reduce costs. We present an overview of the available technologies for the remote monitoring of chronic obstructive pulmonary disease (COPD) patients, together with the most important medical information regarding COPD in a language that is adapted for engineers. Our aim is to bridge the gap between the technical and medical worlds and to facilitate and motivate future research in the field. We also present a justification, motivation, and explanation of how to monitor the most important parameters for COPD patients, together with pointers for the challenges that remain. Additionally, we propose and justify the importance of electrocardiograms (ECGs) and the arterial carbon dioxide partial pressure (PaCO2) as two crucial physiological parameters that have not been used so far to any great extent in the monitoring of COPD patients. We cover four possibilities for the remote monitoring of COPD patients: continuous monitoring during normal daily activities for the prediction and early detection of exacerbations and life-threatening events, monitoring during the home treatment of mild exacerbations, monitoring oxygen therapy applications, and monitoring exercise. We also present and discuss the current approaches to decision support at remote locations and list the normal and pathological values/ranges for all the relevant physiological parameters. The paper concludes with our insights into the future developments and remaining challenges for improvements to continuous remote monitoring systems. Graphical abstractᅟ

show abstract

Combined Oximetry-Cutaneous Capnography in Patients Assessed for Long-term Oxygen Therapy

Cited by 17 publications

References 12 publications

Monitoring of noninvasive ventilation: comparative analysis of different strategies

Monitoring of noninvasive ventilation: comparative analysis of different strategies

Transcutaneous versus blood carbon dioxide monitoring during acute noninvasive ventilation in the emergency department – a retrospective analysis

Continuous remote monitoring of COPD patients—justification and explanation of the requirements and a survey of the available technologies

Contact Info

Product

Resources

About