Associations between clinical interventions and transcutaneous blood gas values in postoperative patients
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Purpose
Postoperative monitoring of circulation and respiration is pivotal to guide intervention strategies and ensure patient outcomes. Transcutaneous blood gas monitoring (TCM) may allow for noninvasive assessment of changes in cardiopulmonary function after surgery, including a more direct assessment of local micro-perfusion and metabolism. To form the basis for studies assessing the clinical impact of TCM complication detection and goal-directed-therapy, we examined the association between clinical interventions in the postoperative period and changes in transcutaneous blood gasses.
Methods
Two-hundred adult patients who have had major surgery were enrolled prospectively and monitored with transcutaneous blood gas measurements (oxygen (TcPO2) and carbon dioxide (TcPCO2)) for 2 h in the post anaesthesia care unit, with recording of all clinical interventions. The primary outcome was changes in TcPO2, secondarily TcPCO2, from 5 min before a clinical intervention versus 5 min after, analysed with paired t-test.
Results
Data from 190 patients with 686 interventions were analysed. During clinical interventions, a mean change in TcPO2 of 0.99 mmHg (95% CI-1.79–0.2, p = 0.015) and TcPCO2 of−0.67 mmHg (95% CI 0.36–0.98, p < 0.001) was detected.
Conclusion
Clinical interventions resulted in significant changes in transcutaneous oxygen and carbon dioxide. These findings suggest future studies to assess the clinical value of changes in transcutaneous PO2 and PCO2 in a postoperative setting.
Postoperative monitoring of circulation and respiration is pivotal to guide intervention strategies and ensure patient outcomes. Transcutaneous blood gas monitoring (TCM) may allow for noninvasive assessment of changes in cardiopulmonary function after surgery, including a more direct assessment of local micro-perfusion and metabolism. To form the basis for studies assessing the clinical impact of TCM complication detection and goal-directed-therapy, we examined the association between clinical interventions in the postoperative period and changes in transcutaneous blood gasses.
Methods
Two-hundred adult patients who have had major surgery were enrolled prospectively and monitored with transcutaneous blood gas measurements (oxygen (TcPO2) and carbon dioxide (TcPCO2)) for 2 h in the post anaesthesia care unit, with recording of all clinical interventions. The primary outcome was changes in TcPO2, secondarily TcPCO2, from 5 min before a clinical intervention versus 5 min after, analysed with paired t-test.
Results
Data from 190 patients with 686 interventions were analysed. During clinical interventions, a mean change in TcPO2 of 0.99 mmHg (95% CI-1.79–0.2, p = 0.015) and TcPCO2 of−0.67 mmHg (95% CI 0.36–0.98, p < 0.001) was detected.
Conclusion
Clinical interventions resulted in significant changes in transcutaneous oxygen and carbon dioxide. These findings suggest future studies to assess the clinical value of changes in transcutaneous PO2 and PCO2 in a postoperative setting.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Clinical Monitoring and Computing |
| Vol/bind | 37 |
| Sider (fra-til) | 1255-1264 |
| Antal sider | 10 |
| ISSN | 1387-1307 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
All authors have made substantial contributions to the study conception and design. EKA and CSM have been responsible for funding acquisition. Data collection was performed by SAT and AOJ, and supervised by EKA and CSM. Data analyses were performed by SAT and AT. The first draft of the manuscript was written by SAT and EKA. All authors have revised it critically and have approved the final version.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature B.V.
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