Optimal Clinical Time for Reliable Measurement of Transcutaneous CO2 with Ear Probes: Counterbalancing Overshoot and the Vasodilatation EffectReportar como inadecuado




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1

Pneumology Service, Hospital de Sabadell, Corporació Parc Taulí, Sabadell 08208, Spain

2

Department of Medicine, Autonomous University of Barcelona UAB, Cerdanyola del Valles, Barcelona 08193, Spain





*

Author to whom correspondence should be addressed.



Abstract OBJECTIVES: To determine the optimal clinical reading time for the transcutaneous measurement of oxygen saturation SpO and transcutaneous CO2 TcPCO2 in awake spontaneously breathing individuals, considering the overshoot phenomenon transient overestimation of arterial PaCO2. EXPERIMENTAL SECTION: Observational study of 91 75 men individuals undergoing forced spirometry, measurement of SpO2 and TcPCO2 with the SenTec monitor every two minutes until minute 20 and arterial blood gas ABG analysis. Overshoot severity: a mild 0.1–1.9 mm Hg; b moderate 2–4.9 mm Hg; c severe: 5 mm Hg. The mean difference was calculated for SpO2 and TcPCO2 and arterial values of PaCO2 and SpO2. The intraclass correlation coefficient ICC between monitor readings and blood values was calculated as a measure of agreement. RESULTS: The mean age was 63.1 ± 11.8 years. Spirometric values: FVC: 75.4 ± 6.2%; FEV1: 72.9 ± 23.9%; FEV1-FVC: 70 ± 15.5%. ABG: PaO2: 82.6 ± 13.2; PaCO2: 39.9.1 ± 4.8 mmHg; SaO2: 95.3 ± 4.4%. Overshoot analysis: overshoot was mild in 33 36.3% patients, moderate in 20 22% and severe in nine 10%; no overshoot was observed in 29 31% patients. The lowest mean differences between arterial blood gas and TcPCO2 was –0.57 mmHg at minute 10, although the highest ICC was obtained at minutes 12 and 14 0.8. The overshoot lost its influence after minute 12. For SpO2, measurements were reliable at minute 2. CONCLUSIONS: The optimal clinical reading measurement recommended for the ear lobe TcPCO2 measurement ranges between minute 12 and 14. The SpO2 measurement can be performed at minute 2. View Full-Text

Keywords: transcutaneous CO2; optimal reading time; overshoot phenomenon transcutaneous CO2; optimal reading time; overshoot phenomenon





Autor: Christian Domingo 1,2,* , Elisa Canturri 1,2, Amalia Moreno 1,2, Humildad Espuelas 1,2, Laura Vigil 1,2 and Manel Luján 1,2

Fuente: http://mdpi.com/



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