Document Detail


Transcutaneous monitoring of partial pressure of carbon dioxide in the elderly patient: a prospective, clinical comparison with end-tidal monitoring.
MedLine Citation:
PMID:  16980160     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To evaluate the accuracy and precision of estimation of partial pressure of carbon dioxide (Pa(CO2)) using end-tidal or transcutaneous CO2 (TcP(CO2)) measurements during mechanical ventilation in the elderly patient. DESIGN: A prospective, observational study was conducted. SETTINGS: The study was done in the anesthesia department of a university hospital. PATIENTS: Seventeen anesthetized, mechanically ventilated patients older than 60 years were studied. INTERVENTIONS AND MEASUREMENTS: During standard sevoflurane anesthesia, and after proper calibration and an equilibration time of 30 minutes with stable hemodynamic and respiratory variables, arterial (Pa(CO2)), end-tidal (Pet(CO2)), and transcutaneous (TcP(CO2)) CO2 partial pressures were determined. In each patient, 1 to 5 sample sets (Pa(CO2), Pet(CO2), and TcP(CO2)) were obtained. MAIN RESULTS: A total of 45 sample sets were obtained from the patients studied. The Pa(CO2) values ranged between 21 and 58 mm Hg. The Pa(CO2) - Pet(CO2) tension gradient was 6 +/- 5 mmHg (95% confidence interval, -3 to 16 mmHg), whereas the Pa(CO2) - TcP(CO2) tension gradient was 2 +/- 4 mmHg (95% confidence interval, -6 to 9 mmHg) (P = 0.0005). The absolute value of the difference between Pa(CO2) and Pet(CO2) was 3 mm Hg or less in 7 of 45 sample sets (15%), whereas the absolute value of the difference between Pa(CO2) and TcP(CO2) was 3 mm Hg or less in 21 of 45 sample sets (46%) (P = 0.003). Linear regression analysis for TcP(CO2) versus Pa(CO2) showed a slope of 0.84 (r(2) = 0.73), whereas the linear regression analysis for Pet(CO2) versus Pa(CO2) showed a slope of 0.54 (r(2) = 0.50). CONCLUSION: Transcutaneous monitoring of CO(2) partial pressure gives a more accurate estimation of arterial CO(2) partial pressure than does Pet(CO2) monitoring.
Authors:
Andrea Casati; Grazia Squicciarini; Giulia Malagutti; Marco Baciarello; Marta Putzu; Andrea Fanelli
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  18     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-18     Completed Date:  2006-10-26     Revised Date:  2007-01-12    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  436-40     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Pain Therapy, University of Parma, and Ospedale Maggiore di Parma, via Gramsci 14, 43100 Parma, Italy. acasati@ao.pr.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Gas Monitoring, Transcutaneous
Capnography / methods*
Carbon Dioxide / blood*
Female
Humans
Linear Models
Male
Middle Aged
Monitoring, Physiologic / methods*
Partial Pressure
Prospective Studies
Respiration, Artificial
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comments/Corrections
Erratum In:
J Clin Anesth. 2006 Nov;18(7):559

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