Document Detail


Continuous monitoring of critically ill patients with transcutaneous oxygen and carbon dioxide and conjunctival oxygen sensors.
MedLine Citation:
PMID:  6435486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transcutaneous (PtcO2) and conjunctival (PcjO2) oxygen tensions and transcutaneous (PtcCO2) carbon dioxide tension were serially measured in 31 critically ill patients. Sixteen patients maintained a normal or greater blood pressure and 15 patients were severely hypotensive (MAP less than 60 mm Hg) or suffered cardiac arrest while in the emergency department. In hemodynamically stable patients, the correlations between PtcO2 and PaO2, PcjO2 and PaO2, and PtcCO2 and PaCO2 were significant, with correlation coefficients (r values) of 0.62, 0.48, and 0.73, respectively. In hemodynamically unstable patients, there was poor correlation between PtcO2, PcjO2, PtcCO2, and arterial blood gas values. In the severely hypotensive patients, however, PtcO2 and PcjO2 were sensitive real-time monitors of peripheral perfusion and tissue oxygen delivery. Increases in PcjO2 and PtcO2 occurred within three minutes in patients who regained a palpable blood pressure from a pulseless baseline. PtcO2 fell one to five minutes after the loss of blood pressure in patients whose clinical condition deteriorated in the emergency department. Decreases in PcjO2 from previously stable levels occurred over three to four minutes before loss of blood pressure. Transcutaneous and conjunctival sensors can be used as continuous monitors of respiratory status in hemodynamically stable patients. In severely hypotensive patients and during cardiopulmonary resuscitation, these sensors no longer accurately reflect arterial blood gases, but act as sensitive real-time monitors of cardiac function and peripheral perfusion. PcjO2 can detect deterioration of clinical state before alterations in blood pressure occur.
Authors:
E Abraham; M Smith; L Silver
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  13     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  1984 Nov 
Date Detail:
Created Date:  1984-11-13     Completed Date:  1984-11-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1021-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure
Carbon Dioxide / blood*
Child
Conjunctiva
Critical Care*
Evaluation Studies as Topic
Female
Heart Arrest / blood
Humans
Hypotension / blood
Male
Middle Aged
Monitoring, Physiologic / methods*
Oxygen / blood*
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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