Continuous intra-arterial blood gas monitoring

Venkatesh, Balasubramanian; Hendry, Stuart P.

doi:10.1007/bf01709527

Cited by 28 publications

(15 citation statements)

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“…The flush solution, at room temperature, contains dissolved oxygen and carbon dioxide at partial pressures similar to that of the atmosphere thus it may alter the local gas tension. As a consequence, the system may measure the blood gas variables in the flush solution, resulting in errors known as the "flush effect" [1,42]. The CDI™ 500 was highly reliable even when the flow decreased significantly during vasoconstriction in contrast with IABG systems which are susceptible to blood flow and when it is low or stops measurements become unreliable [1].…”

Section: Discussionmentioning

confidence: 99%

Assessment of a continuous blood gas monitoring system in animals during circulatory stress

et al. 2011

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BackgroundThe study was aimed to determine the measurement accuracy of The CDI™ blood parameter monitoring system 500 (Terumo Cardiovascular Systems Corporation, Ann Arbor MI) in the real-time continuous measurement of arterial blood gases under different cardiocirculatory stress conditionsMethodsInotropic stimulation (Dobutamine 2.5 and 5 μg/kg/min), vasoconstriction (Arginine-vasopressin 4, 8 and 16 IU/h), hemorrhage (-10%, -20%, -35%, and -50% of the theoretical volemia), and volume resuscitation were induced in ten swine (57.4 ± 10.7 Kg).Intermittent blood gas assessments were carried out using a routine gas analyzer at any experimental phase and compared with values obtained at the same time settings during continuous monitoring with CDI™ 500 system. The Bland-Altman analysis was employed.ResultsBias and precision for pO2 were - 0.06 kPa and 0.22 kPa, respectively (r2 = 0.96); pCO2 - 0.02 kPa and 0.15 kPa, respectively; pH -0.001 and 0.01 units, respectively ( r2 = 0.96). The analysis showed very good agreement for SO2 (bias 0.04,precision 0.33, r2 = 0.95), Base excess (bias 0.04,precision 0.28, r2 = 0.98), HCO3 (bias 0.05,precision 0.62, r2 = 0.92),hemoglobin (bias 0.02,precision 0.23, r2 = 0.96) and K+ (bias 0.02, precision 0.27, r2 = 0.93). The sensor was reliable throughout the experiment during hemodynamic variations.ConclusionsContinuous blood gas analysis with the CDI™ 500 system was reliable and it might represent a new useful tool to accurately and timely monitor gas exchange in critically ill patients. Nonetheless, our findings need to be confirmed by larger studies to prove its reliability in the clinical setting.

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Section: Discussionmentioning

confidence: 99%

Assessment of a continuous blood gas monitoring system in animals during circulatory stress

et al. 2011

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“…Currently available tonometers have equilibration periods ranging between 10 and 90 min [16,17,18,19] and are therefore not efficient for rapid detection of changes in tissue perfusion on a continuous basis. Fiberoptic sensors that are used in clinical medicine for automatic and continuous measurements of blood gases [43,44] have a rapid response time [45]. Experimental evaluation of a fiberoptic P CO 2 sensor, similar to that used in the present study, has shown a high degree of precision in detecting short-term changes in intramucosal P CO 2 [35].…”

Section: Discussionmentioning

confidence: 99%

Esophageal capnometry during hemorrhagic shock and after resuscitation in rats

et al. 2002

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Correspondence: Dan Torbati, Dan.Torbati@MCH.Com 79 HR = heart rate; MABP = mean arterial blood pressure; PaCO 2 = arterial partial carbon dioxide tension; PCO 2 = partial carbon dioxide tension; PeCO 2 = esophageal partial carbon dioxide tension. AbstractBackground Splanchnic perfusion following hypovolemic shock is an important marker of adequate resuscitation. We tested whether the gap between esophageal partial carbon dioxide tension (PeCO 2 ) and arterial partial carbon dioxide tension (PaCO 2 ) is increased during graded hemorrhagic hypotension and reversed after blood reinfusion, using a fiberoptic carbon dioxide sensor. Materials and method Ten Sprague-Dawley rats were anesthetized, tracheotomized, and cannulated in one femoral artery and vein. A calibrated fiberoptic PCO 2 probe was inserted into the distal third of the esophagus for determination of luminal PeCO 2 during maintained anesthesia (pentobarbital 15 mg/kg per hour), normothermia (38 ± 0.5°C), and fluid balance (saline 5 ml/kg per hour). Three out of 10 rats were used to determine the limits of hemodynamic stability during gradual hemorrhage. Seven of the 10 rats were then subjected to mild and severe hemorrhage (15 and 20-25 ml/kg, respectively). Thirty minutes after severe hemorrhage, these rats were resuscitated by reinfusion of the shed blood. Arterial gas exchange, hemodynamic variables, and PeCO 2 were recorded at each steadystate level of hemorrhage (at 30 and 60 min) and after resuscitation. Results The PeCO 2 -PaCO 2 gap was significantly increased after mild and severe hemorrhage and returned to baseline (prehemorrhagic) values following blood reinfusion. Base deficit increased significantly following severe hemorrhage and remained significantly elevated after blood reinfusion. Significant correlations were found between base deficit and PeCO 2 -PaCO 2 (P < 0.002) and PeCO 2 (P < 0.022). Blood bicarbonate concentration decreased significantly following mild and severe hemorrhage, but its recovery was not complete at 60 min after blood reinfusion. Conclusion Esophageal-arterial PCO 2 gap increases during graded hemorrhagic hypotension and returns to baseline value after resuscitation without complete reversal of the base deficit. These data suggest that esophageal capnometry could be used as an alternative for gastric tonometry during management of hypovolemic shock.

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“…Fluorescence quenching on exposure to oxygen provides an attractive approach to the development of an oxygen sensor. In the past two decades, two continuous intravascular blood gas monitoring (CIBM) systems, Paratrend 7+ (Diametrics Medical Inc., High Wycombe, UK) and Neotrend (Diametrics Medical Inc. High Wycombe, UK), have been developed based on a fluorescence quenching mechanism 5,10–12 . The Paratrend 7+ is a hybrid probe incorporating three different sensors: an optical fluorescent sensor to measure the partial pressure of oxygen (PO 2 ), optodes to measure the partial pressure of carbon dioxide (PCO 2 ) and pH.…”

Section: Introductionmentioning

confidence: 99%

“…In the past two decades, two continuous intravascular blood gas monitoring (CIBM) systems, Paratrend 7+ (Diametrics Medical Inc., High Wycombe, UK) and Neotrend (Diametrics Medical Inc. High Wycombe, UK), have been developed based on a fluorescence quenching mechanism. 5,[10][11][12] The Paratrend 7+ is a hybrid probe incorporating three different sensors: an optical fluorescent sensor to measure the partial pressure of oxygen (PO2), optodes to measure the partial pressure of carbon dioxide (PCO2) and pH. Neotrend, a modification of the Paratrend 7+, was designed for CIBM in the umbilical artery of newborn infants using the same sensors as in the Paratrend 7+.…”

Section: Introductionmentioning

confidence: 99%

“…However, these two systems have only been used in limited animal studies and there has been little uptake by clinical practice due to their high cost, fragility of the fibres and inaccuracies. 13 We have developed a fluorescence oxygen sensor for continuous intravascular PO2 monitoring in vivo that has high stability and biocompatibility, high accuracy regardless of changes in pH, osmolality, protein concentration and CO2 levels. 14 In this study, we tested the sensitivity, reproducibility and stability of the optical sensor in an animal model with and without lung injury, to evaluate the potential application of the oxygen sensor in vivo.…”

Section: Introductionmentioning

confidence: 99%

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