Evaluation of a transcutaneous carbon dioxide monitor in severe obesity

Maniscalco, Mauro; Zedda, Anna; Faraone, Stanislao; Carratù, Pierluigi; Miceli, Sofia

doi:10.1007/s00134-008-1078-8

Cited by 50 publications

(32 citation statements)

References 13 publications

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“…Basing on the results of our study, we may speculate that local conditions at the site of sensor location, including the thickness and conductivity of the skin are more important for PtcO 2 and PtcCO 2 measurement than whole body composition (Kesten et al 1991). This is supported by the findings of other authors who demonstrated that even in morbidly obese patients PtcCO 2 monitoring is a reliable method and its results correlate with arterial blood gases (Soto et al 2014;Maniscalco et al 2008).…”

Section: Discussionsupporting

confidence: 84%

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Variability of Transcutaneous Oxygen and Carbon Dioxide Pressure Measurements Associated with Sensor Location

Górska

Korczyński

Maskey-Warzęchowska

et al. 2015

Advances in Experimental Medicine and Biology

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Transcutaneous measurement of oxygen and carbon dioxide pressure (PtcO2 and PtcCO2) is useful in gas exchange monitoring. However, the relationship between PtcO2, pulse oximetry (SaO2) and arterial blood gases (ABG) is unclear. The aim of the present study was to compare PtcO2 and PtcCO2 with SaO2 and ABG, to evaluate the effect of sensor location on the results and stability of PtcO2 and PtcCO2, and to assess the impact of body composition on PtcO2 and PtcCO2. PtcO2 and PtcCO2 were measured in 20 healthy volunteers at three locations: right second intercostal space, lateral surface of the abdomen, and the inner surface of the left arm. The results were recorded 10, 15, and 20 min after sensor fixation and compared with SaO2 and ABG measured 20 min after electrode placement on the chest. Body composition was evaluated by bioimpedance. The findings were that PtcO2 was stable on the chest; but on the arm and abdomen it increased and reached maximum at 20 min. Transcutaneous PCO2 stabilized at 10 min in all the three locations. No significant correlations between PtcO2 and SaO2 or PaO2 were found. Transcutaneous PCO2 correlated with PaCO2. Both PtcO2 and PtcCO2 were not influenced by body composition. We conclude that the value of PtcO2 in monitoring of blood oxygenation was not unequivocally confirmed; PtcCO2 reliably reflects PaCO2, irrespective of sensor location. Body composition does not affect PtcO2 and PtcCO2.

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Section: Discussionsupporting

confidence: 84%

“…However, some authors documented that transcutaneous gas tensions do not depend on body mass index (BMI) (Soto et al 2014;Maniscalco et al 2008;Janssens et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Variability of Transcutaneous Oxygen and Carbon Dioxide Pressure Measurements Associated with Sensor Location

Górska

Korczyński

Maskey-Warzęchowska

et al. 2015

Advances in Experimental Medicine and Biology

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“…Body mass index, tissue hypoperfusion, and the use of vasoconstricting drugs may affect accuracy. 18,19,20 In line with the results of Maniscalco et al, 21 which found a good agreement between P aCO 2 and P tcCO 2 (bias 1.3 mm Hg and limits of agreement Ϫ4 to 1.1) in a study of severe obese subjects (body mass index 43.7 kg/m 2 ), we considered that the body mass index of our subjects (mean 34 kg/m 2 ) did not affect the accuracy of P tcCO 2 . On the other hand, only 2 hypotensive subjects were included.…”

Section: Discussionsupporting

confidence: 75%

Transcutaneous Carbon Dioxide Monitoring in Subjects With Acute Respiratory Failure and Severe Hypercapnia

et al. 2016

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BACKGROUND: Transcutaneous carbon dioxide (P tcCO 2 ) monitoring is being used increasingly to assess acute respiratory failure. However, there are conflicting findings concerning its reliability when evaluating patients with high levels of P aCO 2 . Our study evaluates the accuracy of this method in subjects with respiratory failure according to the severity of hypercapnia. METHODS: We included subjects with respiratory failure, admitted to a respiratory intermediate care unit, who required arterial blood gas analysis. Simultaneously, P tcCO 2 was measured using a digital monitor. Relations between P aCO 2 and P tcCO 2 were assessed by the Pearson correlation coefficient. BlandAltman analysis was used to test data dispersion, and an analysis of variance test was used to compare the differences between P aCO 2 and the corresponding P tcCO 2 at different levels (level 1, <50 mm Hg; level 2, 50 -60 mm Hg; level 3, >60 mm Hg). RESULTS: Eighty-one subjects were analyzed. The main diagnosis was COPD exacerbation (45%). P tcCO 2 correlated well with P aCO 2 (r2 ‫؍‬ 0.93, P < .001). Bland-Altman analysis showed a mean P aCO 2 ؊ P tcCO 2 difference of 4.9 ؎ 4.4 with 95% limits of agreement ranging from ؊3.6 to 13.4. The difference between variables increased in line with P aCO 2 severity: level 1, 1.7 ؎ 3.2 mm Hg; level 2, 3.7 ؎ 2.8; level 3, 6.8 ؎ 4.7 (analysis of variance, P < .001). CONCLUSIONS: Our study showed an acceptable agreement of P tcCO 2 monitoring with arterial blood gas analysis. However, we should consider that P tcCO 2 underestimates P aCO 2 levels, and its accuracy depends on the level of hypercapnia, so this method would not be suitable for acute patients with severe hypercapnia.

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“…Intra-individual analysis of the agreement between PtcCO 2 and PaCO 2 data pairs collected after extubation of the two patients showed no considerable differences to the patients whose lungs were ventilated. These findings are supported by a study most recently published by Maniscalco and colleagues [22] and performed in severely obese and clinically unstable patients using the TOSCA device (Linde Medical Sensors AG, Basel, Switzerland). These authors reported good agreement of PtcCO 2 and PaCO 2 in both spontaneously breathing and ventilated patients.…”

Section: Discussionsupporting

confidence: 79%

The Revised Digital Transcutaneous PCO2/SpO2 Ear Sensor Is a Reliable Noninvasive Monitoring Tool in Patients After Cardiac Surgery

Roediger

Beck‐Schimmer

Theusinger

et al. 2011

Journal of Cardiothoracic and Vascular Anesthesia

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Evaluation of a transcutaneous carbon dioxide monitor in severe obesity

Abstract: The accuracy of estimation of PaCO(2) by transcutaneous monitoring was generally good in comparison with standard arterial blood gases examination. The device appears to be promising for use in obese patients to evaluate abnormalities in their alveolar ventilation.

Cited by 50 publications

References 13 publications

Variability of Transcutaneous Oxygen and Carbon Dioxide Pressure Measurements Associated with Sensor Location

Variability of Transcutaneous Oxygen and Carbon Dioxide Pressure Measurements Associated with Sensor Location

Transcutaneous Carbon Dioxide Monitoring in Subjects With Acute Respiratory Failure and Severe Hypercapnia

The Revised Digital Transcutaneous PCO2/SpO2 Ear Sensor Is a Reliable Noninvasive Monitoring Tool in Patients After Cardiac Surgery

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