Agreement between transcutaneous monitoring and arterial blood gases during COPD exacerbation
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Agreement between transcutaneous monitoring and arterial blood gases during COPD exacerbation. / Sørensen, Kasper M.; Leicht, Rebecca V.; Carlsson, Christian J.; Elvekjaer, Mikkel; Porsbjerg, Celeste; Aasvang, Eske K.; Meyhoff, Christian S.
I: Respiratory Care, Bind 66, Nr. 10, 2021, s. 1560-1566.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Agreement between transcutaneous monitoring and arterial blood gases during COPD exacerbation
AU - Sørensen, Kasper M.
AU - Leicht, Rebecca V.
AU - Carlsson, Christian J.
AU - Elvekjaer, Mikkel
AU - Porsbjerg, Celeste
AU - Aasvang, Eske K.
AU - Meyhoff, Christian S.
N1 - Publisher Copyright: © 2021 Daedalus Enterprises.
PY - 2021
Y1 - 2021
N2 - 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 trans-cutaneous 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 (DPtcCO2 and DPtcO2). 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 DPtcCO2 and DPtcO2 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 pe-riod was acceptable, however, and transcutaneous monitoring may be used for continuous monitoring of PCO2 in conjunction with arterial blood gas analysis for reference.
AB - 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 trans-cutaneous 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 (DPtcCO2 and DPtcO2). 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 DPtcCO2 and DPtcO2 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 pe-riod was acceptable, however, and transcutaneous monitoring may be used for continuous monitoring of PCO2 in conjunction with arterial blood gas analysis for reference.
KW - COPD
KW - Hypercapnia
KW - Intensive care
KW - Noninvasive ventilation
KW - Respiratory insuffi-ciency
KW - Transcutaneous blood gas monitoring
U2 - 10.4187/respcare.08510
DO - 10.4187/respcare.08510
M3 - Journal article
C2 - 34074743
AN - SCOPUS:85116665705
VL - 66
SP - 1560
EP - 1566
JO - Respiratory Care
JF - Respiratory Care
SN - 0020-1324
IS - 10
ER -
ID: 284106598