Agreement Between Transcutaneous Monitoring and Arterial Blood Gases During COPD Exacerbation
| Autor: | Rebecca V Leicht, Celeste Porsbjerg, Christian J. Carlsson, Eske Kvanner Aasvang, Christian S. Meyhoff, Mikkel Elvekjaer, Kasper M Sørensen |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult medicine.medical_specialty Exacerbation Critical Care and Intensive Care Medicine Hypercapnia Pulmonary Disease Chronic Obstructive Intensive care Internal medicine medicine Humans Respiratory system Original Research COPD Noninvasive Ventilation business.industry General Medicine Carbon Dioxide medicine.disease Copd exacerbation Cardiology Arterial blood Noninvasive ventilation medicine.symptom business Blood Gas Monitoring Transcutaneous |
| Zdroj: | Respir Care |
| ISSN: | 1943-3654 |
| Popis: | BACKGROUND: Transcutaneous measurements of CO2 and O2 ( P tcCO 2 , P tcO 2 ) are noninvasive and allow for continuous monitoring in adults with exacerbation of COPD, but substantial accuracy issues may exist. We investigated agreement between results of arterial blood gas analysis and transcutaneous measurements of CO2 and O2 in patients with COPD. METHODS: Adult subjects were monitored after acute admission to a respiratory intermediate care unit or ICU due to exacerbation of COPD and with ongoing noninvasive ventilation or immediately following extubation. Monitored variables were continuous transcutaneous measurement and simultaneous routine arterial blood gas analysis. Agreement between measurements was assessed by calculating bias with 95% limits of agreement for single-point estimates of P tcCO 2 versus P aCO 2 and versus P aO 2 , and for changes in transcutaneous measurements between 2 time points ( Δ P tcCO 2 and Δ P tcO 2 ). We considered limits of agreement within ± 7.5 mm Hg to be acceptable. RESULTS: A total of 57 transcutaneous measurements were made in 20 subjects for comparison with concurrent arterial blood gas analysis at 36 time points. The bias (limits of agreement) for P tcCO 2 and P tcO 2 was 2.5 mm Hg (–10.6 to 15.6 mm Hg) and 11.2 mm Hg (–28.2 to 50.6 mm Hg), respectively. The bias for Δ P tcCO 2 and Δ P tcO 2 was 2.3 mm Hg (–3.8 to 8.3 mm Hg) and –5.3 mm Hg (–37.5 to 27 mm Hg), respectively. CONCLUSIONS: P tcCO 2 and P tcO 2 did not accurately reflect results from arterial blood gas analyses in this study of mostly hypercapnic subjects. Agreement between changes in CO2 during the monitoring period was acceptable, however, and transcutaneous monitoring may be used for continuous monitoring of P CO 2 in conjunction with arterial blood gas analysis for reference. |
| Databáze: | OpenAIRE |
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