Transcutaneous carbon dioxide measurements in anesthetized apneic patients with BMI > 35 kg/m 2 .

Autor: Eley VA; Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD, 4029, Australia. v.eley@uq.edu.au.; Faculty of Medicine, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia. v.eley@uq.edu.au.; Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, 4006, Australia. v.eley@uq.edu.au., Guy L; Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD, 4029, Australia.; Faculty of Medicine, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia., Woods C; Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD, 4029, Australia., Llewellyn S; Statistics Unit, QIMR Berghofer Medical Research Institute, Herston Road, Herston, QLD, 4006, Australia., Van Zundert AAJ; Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD, 4029, Australia.; Faculty of Medicine, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia.
Jazyk: angličtina
Zdroj: Journal of anesthesia [J Anesth] 2023 Dec; Vol. 37 (6), pp. 971-975. Date of Electronic Publication: 2023 Oct 10.
DOI: 10.1007/s00540-023-03263-8
Abstrakt: Transcutaneous carbon dioxide measurement (TcCO 2 ) offers the ability to continuously and non-invasively monitor carbon dioxide (CO 2 ) tensions when end-tidal monitoring is not possible. The accuracy of TcCO 2 has not been established in anesthetized apneic patients with obesity. In this secondary publication, we present a methods comparison analysis of TcCO 2 with the gold standard arterial PCO 2 , in adult patients with body mass index (BMI) > 35kg/m 2 who were randomized to receive high flow or low flow nasal oxygenation during post-induction apnea. Agreement between PaCO 2 and TcCO 2 at baseline, the start of apnea and the end of apnea were assessed using a non-parametric difference plot. Forty-two participants had a median (IQR) BMI of 52 (40-58.5) kg/m 2 . The mean (SD) PaCO 2 was 33.9 (4.0) mmHg at baseline and 51.4 (7.5) mmHg at the end of apnea. The bias was the greatest at the end of apnea median (95% CI, 95% limits of agreement) 1.90 mmHg (-2.64 to 6.44, -7.10 to 22.90). Findings did not suggest significant systematic differences between the PaCO 2 and TcCO 2 measures. For a short period of apnea, TcCO 2 showed inadequate agreement with PaCO 2 in patients with BMI > 35 kg/m 2 . These techniques require comparison in a larger population, with more frequent sampling and over a longer timeframe, before TcCO 2 can be confidently recommended in this setting.
(© 2023. The Author(s).)
Databáze: MEDLINE
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