Universität zu Köln

Spelten, Oliver, Fiedler, Fritz, Schier, Robert, Wetsch, Wolfgang A. and Hinkelbein, Jochen (2017). Transcutaneous PtcCO(2) measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients. J. Clin. Monitor. Comp., 31 (1). S. 153 - 159. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1573-2614

Full text not available from this repository.

Abstract

Hyper or hypoventilation may have serious clinical consequences in critically ill patients and should be generally avoided, especially in neurosurgical patients. Therefore, monitoring of carbon dioxide partial pressure by intermittent arterial blood gas analysis (PaCO2) has become standard in intensive care units (ICUs). However, several additional methods are available to determine PCO2 including end-tidal (PetCO(2)) and transcutaneous (PtcCO(2)) measurements. The aim of this study was to compare the accuracy and reliability of different methods to determine PCO2 in mechanically ventilated patients on ICU. After approval of the local ethics committee PCO2 was determined in n = 32 ICU consecutive patients requiring mechanical ventilation: (1) arterial PaCO2 blood gas analysis with Radiometer ABL 625 (ABL; gold standard), (2) arterial PaCO2 analysis with Immediate Response Mobile Analyzer (IRMA), (3) end-tidal PetCO(2) by a Propaq 106 EL monitor and (4) transcutaneous PtcCO(2) determination by a Tina TCM4. Bland-Altman method was used for statistical analysis; p < 0.05 was considered statistically significant. Statistical analysis revealed good correlation between PaCO2 by IRMA and ABL (R-2 = 0.766; p < 0.01) as well as between PtcCO(2) and ABL (R-2 = 0.619; p < 0.01), whereas correlation between PetCO(2) and ABL was weaker (R-2 = 0.405; p < 0.01). Bland-Altman analysis revealed a bias and precision of 2.0 +/- 3.7 mmHg for the IRMA, 2.2 +/- 5.7 mmHg for transcutaneous, and -5.5 +/- 5.6 mmHg for end-tidal measurement. Arterial CO2 partial pressure by IRMA (PaCO2) and PtcCO(2) provided greater accuracy compared to the reference measurement (ABL) than the end-tidal CO2 measurements in critically ill in mechanically ventilated patients patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Spelten, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Fiedler, Fritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Schier, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Wetsch, Wolfgang A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hinkelbein, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-241715
DOI:	10.1007/s10877-015-9810-8
Journal or Publication Title:	J. Clin. Monitor. Comp.
Volume:	31
Number:	1
Page Range:	S. 153 - 159
Date:	2017
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1573-2614
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TIDAL CARBON-DIOXIDE; INTENSIVE-CARE UNITS; CRITICALLY-ILL; PCO2 TCPCO2; ADULTS; PRECISION; PACO2; UK Multiple languages Anesthesiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24171