Transcutaneous arterial carbon dioxide pressure monitoring in critically ill adult patients

Abstract

Transcutaneous PCO(2) provides a safe and reliable trend-monitoring tool, provided there is no major vasoconstriction.

Transcutaneous carbon dioxide monitoring

“…We have not reported these data in detail but stated in the Results section that vasopressors did not influence the accuracy of P tc CO 2 monitoring in our study patients. As mentioned in the discussion, these findings are in agreement with those of two recent studies [1,2] that also failed to find an influence of administered of vasopressors on P tc CO 2 measurements.…”

“…The results from the TOSCA monitor, with a mean bias of ) 0.29 kPa and 85% of readings being within the clinically accepted limits of agreement compares favourably with the findings of Bendjelid et al [2], where mean bias was ) 0.16 kPa and 81% of P tc CO 2 values were within the clinically acceptable limits of agreement of 1 kPa from the P a CO 2 . We have performed a similar study in the general critical care population demonstrating a mean bias of ) 0.27 kPa at normocarbia (< 6.7 kPa), and 90% of values P tc CO 2 being within 1 kPa of P a CO 2 [3].…”

“…The literature appears to support this view. Asai and Shingu's review article of solutions to difficulties in advancing the tracheal tube over a bronchoscope suggests using as small a tracheal tube as feasible over the conduit to reduce the incidence of difficulty [2]. Also, the guidelines produced by the Difficult Airway Society advocate the use of a small tracheal tube to facilitate railroading over the Eschmann introducer as part of Plan A: initial tracheal intubation [3].…”

Transcutaneous Measurement of Carbon Dioxide Tension During Extended Monitoring: Evaluation of Accuracy and Stability, and an Algorithm for Correcting Calibration Drift

“…4,[13][14][15][16][17][18] The reasons for the observed differences between P aCO 2 and P tcCO 2 have previously been reviewed. 19 However, we would attest that the aim of continuous CO 2 measurement during extended sleep monitoring is to detect sleep-related changes that suggest the presence or adequate control of hypoventilation, rather than as a direct measure of P aCO 2 per se (ie, monitoring changes during sleep, rather than measuring absolute values), so noninvasive devices that can detect change over an extended monitoring period with sufficient accuracy and minimal artifactual drift have substantial clinical utility.…”

Analysis of mean transcutaneous capnography in consecutive patients undergoing polysomnography

“…Such differences tend to remain constant during data capture 8,9 . In addition, cutaneous arterialization processes were found to be safe at temperatures up to 44°C, allowing the electrode to remain in contact with the patient for a longer period of time without damages 5,10 . These improvements have contributed to increase reliability and safety of the method 1 .…”