Non-invasive monitoring of carboxyhemoglobin during hyperbaric oxygen therapy
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Non-invasive monitoring of carboxyhemoglobin during hyperbaric oxygen therapy. / Bidstrup, Daniel; Ravn, Frederikke; Smidt-Nielsen, Isabel Guida; Wahl, Anna Mygind; Jansen, Erik Christian; Hyldegaard, Ole.
I: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc, Bind 48, Nr. 1, 01.01.2021, s. 33-42.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Non-invasive monitoring of carboxyhemoglobin during hyperbaric oxygen therapy
AU - Bidstrup, Daniel
AU - Ravn, Frederikke
AU - Smidt-Nielsen, Isabel Guida
AU - Wahl, Anna Mygind
AU - Jansen, Erik Christian
AU - Hyldegaard, Ole
N1 - Publisher Copyright: Copyright© Undersea and Hyperbaric Medical Society.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Introduction: This study aimed to assess the capability of a pulse CO-oximeter to continuously monitor carboxyhemoglobin (COHb) during hyperbaric oxygen (HBO2) therapy. We estimated limits of agreement (LOA) between blood gas analysis and pulse CO-oximeter for COHb during HBO2 therapy in patients suffering from acute CO poisoning. Furthermore, we did a medicotechnical evaluation of the pulse CO-oximeter in hyperbaric conditions. Methods: We conducted a prospective, non-clinical, observational study in which we included n=10 patients with acute CO poisoning referred for HBO2 therapy. We did five repeated measurements of COHb for each patient during the HBO2 therapy. Bland-Altman analysis for multiple observations per individual was used to assess the agreement. The a priori LOA was ±6% for COHb. For the medicotechnical evaluation continuous measurements were obtained throughout each complete HBO2 therapy. The measurements were visually inspected and evaluated. Results: The Bland-Altman analysis showed that the pulse CO-oximeter overestimated COHb by 2.9 % [±1.0%] and the LOA was ±7.3% [±1.8%]. The continuous measurements by pulse CO-oximetry showed fluctuating levels of COHb and summarized saturations reached levels above 100%. Measurements were not affected by changes in pressure. Conclusion: To our knowledge, this study is the first to assess LOA and demonstrate use of a non-invasive method to measure COHb during HBO2 therapy. The pulse CO-oximeter performed within the manufactures reported LOA (±6%) despite hyperbaric conditions and was unaffected by changes in pressure. However, summarized saturations reached levels above 100%.
AB - Introduction: This study aimed to assess the capability of a pulse CO-oximeter to continuously monitor carboxyhemoglobin (COHb) during hyperbaric oxygen (HBO2) therapy. We estimated limits of agreement (LOA) between blood gas analysis and pulse CO-oximeter for COHb during HBO2 therapy in patients suffering from acute CO poisoning. Furthermore, we did a medicotechnical evaluation of the pulse CO-oximeter in hyperbaric conditions. Methods: We conducted a prospective, non-clinical, observational study in which we included n=10 patients with acute CO poisoning referred for HBO2 therapy. We did five repeated measurements of COHb for each patient during the HBO2 therapy. Bland-Altman analysis for multiple observations per individual was used to assess the agreement. The a priori LOA was ±6% for COHb. For the medicotechnical evaluation continuous measurements were obtained throughout each complete HBO2 therapy. The measurements were visually inspected and evaluated. Results: The Bland-Altman analysis showed that the pulse CO-oximeter overestimated COHb by 2.9 % [±1.0%] and the LOA was ±7.3% [±1.8%]. The continuous measurements by pulse CO-oximetry showed fluctuating levels of COHb and summarized saturations reached levels above 100%. Measurements were not affected by changes in pressure. Conclusion: To our knowledge, this study is the first to assess LOA and demonstrate use of a non-invasive method to measure COHb during HBO2 therapy. The pulse CO-oximeter performed within the manufactures reported LOA (±6%) despite hyperbaric conditions and was unaffected by changes in pressure. However, summarized saturations reached levels above 100%.
KW - carbon monoxide
KW - exogenous poison
KW - high-pressure biology
KW - hyperbaric oxygen therapy
KW - pressure chambers
KW - toxicity
KW - transcutaneous oximetry
U2 - 10.22462/01.03.2021.4
DO - 10.22462/01.03.2021.4
M3 - Journal article
C2 - 33648031
AN - SCOPUS:85102331089
VL - 48
SP - 33
EP - 42
JO - Undersea and Hyperbaric Medicine
JF - Undersea and Hyperbaric Medicine
SN - 1066-2936
IS - 1
ER -
ID: 286995959