Limits of tcPo2Monitoring in Sick Neonates: Relation to Blood Pressure, Blood Volume, Peripheral Blood Flow and Acid Base Status

Versmold, Hans T.; Linderkamp, Otwin; Holzmann, M.; Strohhacker, I.; Riegel, K

doi:10.1111/j.1399-6576.1978.tb01399.x

Cited by 33 publications

(6 citation statements)

References 5 publications

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“…Oxygen measured transcutaneously has typically been less closely associated with arterial levels than is the case for carbon dioxide. In neonates, correlation coefficients ranging from 0.72 to 0.98 have been reported 2 ,8,II,14, [16][17][18][19]. The mean differences between T0 2 and p0 2 in infants have been reported as 3 mmHg'6 while the bias and precision has been reported as 2.8±16.0 mmHg", 12.5±13.0 mmHg'S and 16.4±24.7 mmHg at p0 2 greater than 80 mmHg and 3.0±1O.2 mmHg at lower P022.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po₂ and Pco₂ in Neonates

Carter

Hochmann

Osborne

et al. 1995

Anaesth Intensive Care

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Section: Discussionmentioning

confidence: 99%

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po₂ and Pco₂ in Neonates

Carter

Hochmann

Osborne

et al. 1995

Anaesth Intensive Care

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“…The considerable increase in local blood flow equilibrates skin carbon dioxide (CO 2 ) and oxygen (O 2 ) levels to arterial values, reducing the contribution of local CO 2 production and O 2 consumption [ 7 ]. It has been shown that changes in local skin perfusion caused by changes in temperature and blood pressure can still have a notable effect on blood gas diffusion, and with it sensor accuracy [ 6 , 8 , 9 ]. The fact that O 2 diffuses 20 times slower than CO 2 makes it more prone to these changes, despite adequate heating of the skin [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Improving the Clinical Interpretation of Transcutaneous Carbon Dioxide and Oxygen Measurements in the Neonatal Intensive Care Unit

et al. 2023

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Introduction: Transcutaneous blood gas monitoring allows for continuous non-invasive evaluation of carbon dioxide and oxygen levels. Its use is limited as its accuracy is dependent on several factors. We aimed to identify the most influential factors to increase usability and aid in the interpretation of transcutaneous blood gas monitoring. Methods: In this retrospective cohort study, transcutaneous blood gas measurements were paired to arterial blood gas withdrawals in neonates admitted to the neonatal intensive care unit. The effects of patient-related, microcirculatory, macrocirculatory, respiratory, and sensor-related factors on the difference between transcutaneously and arterially measured carbon dioxide and oxygen values (ΔPCO2 and ΔPO2) were evaluated using marginal models. Results: A total of 1,578 measurement pairs from 204 infants with a median [interquartile range] gestational age of 273/7 [261/7–313/7] weeks were included. ΔPCO2 was significantly associated with the postnatal age, arterial systolic blood pressure, body temperature, arterial partial pressure of oxygen (PaO2), and sensor temperature. ΔPO2 was, with the exception of PaO2, additionally associated with gestational age, birth weight Z-score, heating power, arterial partial pressure of carbon dioxide, and interactions between sepsis and body temperature and sepsis and the fraction of inspired oxygen. Conclusion: The reliability of transcutaneous blood gas measurements is affected by several clinical factors. Caution is recommended when interpreting transcutaneous blood gas values with an increasing postnatal age due to skin maturation, lower arterial systolic blood pressures, and for transcutaneously measured oxygen values in the case of critical illness.

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“…Transcutaneous blood gas sensors locally heat the skin to induce vasodilation, resulting in an increase in supplied O 2 and clearance of CO 2 [2,3]. The diffusion capacity of the skin is however markedly lower for O 2 than for CO 2 [4], additionally influenced by the thickness [5,6] and microcirculatory condition [7] of the skin. As a consequence the measurement of transcutaneous oxygen (tcPO 2 ) [8] requires relatively high sensor temperatures of 43 to 44°C [9] for tcPO 2 to correlate with arterial oxygen tension (PaO 2 ), which due to skin thickness only results in tcPO 2 values approaching PaO 2 in infants and young children [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Novel transcutaneous sensor combining optical tcPO2 and electrochemical tcPCO2 monitoring with reflectance pulse oximetry

Weteringen

Goos

Essen

et al. 2019

Med Biol Eng Comput

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This study investigated the accuracy, drift, and clinical usefulness of a new optical transcutaneous oxygen tension (tcPO 2) measuring technique, combined with a conventional electrochemical transcutaneous carbon dioxide (tcPCO 2) measurement and reflectance pulse oximetry in the novel transcutaneous OxiVenT™ Sensor. In vitro gas studies were performed to measure accuracy and drift of tcPO 2 and tcPCO 2. Clinical usefulness for tcPO 2 and tcPCO 2 monitoring was assessed in neonates. In healthy adult volunteers, measured oxygen saturation values (SpO 2) were compared with arterially sampled oxygen saturation values (SaO 2) during controlled hypoxemia. In vitro correlation and agreement with gas mixtures of tcPO 2 (r = 0.999, bias 3.0 mm Hg, limits of agreement − 6.6 to 4.9 mm Hg) and tcPCO 2 (r = 0.999, bias 0.8 mm Hg, limits of agreement − 0.7 to 2.2 mm Hg) were excellent. In vitro drift was negligible for tcPO 2 (0.30 (0.63 SD) mm Hg/24 h) and highly acceptable for tcPCO 2 (− 2.53 (1.04 SD) mm Hg/12 h). Clinical use in neonates showed good usability and feasibility. SpO 2-SaO 2 correlation (r = 0.979) and agreement (bias 0.13%, limits of agreement − 3.95 to 4.21%) in healthy adult volunteers were excellent. The investigated combined tcPO 2 , tcPCO 2 , and SpO 2 sensor with a new oxygen fluorescence quenching technique is clinically usable and provides good overall accuracy and negligible tcPO 2 drift. Accurate and low-drift tcPO 2 monitoring offers improved measurement validity for long-term monitoring of blood and tissue oxygenation. Keywords Transcutaneous. tcPO 2. tcPCO 2. Oxygen. Fluorescence quenching * Willem van Weteringen

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Limits of tcP_o2Monitoring in Sick Neonates: Relation to Blood Pressure, Blood Volume, Peripheral Blood Flow and Acid Base Status

Cited by 33 publications

References 5 publications

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po₂ and Pco₂ in Neonates

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po₂ and Pco₂ in Neonates

Improving the Clinical Interpretation of Transcutaneous Carbon Dioxide and Oxygen Measurements in the Neonatal Intensive Care Unit

Novel transcutaneous sensor combining optical tcPO2 and electrochemical tcPCO2 monitoring with reflectance pulse oximetry

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Limits of tcPo2Monitoring in Sick Neonates: Relation to Blood Pressure, Blood Volume, Peripheral Blood Flow and Acid Base Status

Cited by 33 publications

References 5 publications

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po2 and Pco2 in Neonates

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po2 and Pco2 in Neonates

Improving the Clinical Interpretation of Transcutaneous Carbon Dioxide and Oxygen Measurements in the Neonatal Intensive Care Unit

Novel transcutaneous sensor combining optical tcPO2 and electrochemical tcPCO2 monitoring with reflectance pulse oximetry

Contact Info

Product

Resources

About

Limits of tcP_o2Monitoring in Sick Neonates: Relation to Blood Pressure, Blood Volume, Peripheral Blood Flow and Acid Base Status

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po₂ and Pco₂ in Neonates

A Comparison of Two Transcutaneous Monitors for the Measurement of Arterial Po₂ and Pco₂ in Neonates