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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Agreement Between Transcutaneous Monitoring and Arterial Blood Gases During COPD Exacerbation

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

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BACKGROUND: Transcutaneous measurements of CO2 and O2 (PtcCO2 , PtcO2 ) 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 PtcCO2 versus PaCO2 and versus PaO2 , and for changes in transcutaneous measurements between 2 time points (ΔPtcCO2 and ΔPtcO2 ). 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 PtcCO2 and PtcO2 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 ΔPtcCO2 and ΔPtcO2 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: PtcCO2 and PtcO2 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 PCO2 in conjunction with arterial blood gas analysis for reference.

Original languageEnglish
JournalRespiratory Care
ISSN0020-1324
DOIs
Publication statusE-pub ahead of print - 1 Jun 2021

ID: 65947890