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Comparison of the transcutaneous oxygen and carbon dioxide tension in different electrode locations during general anaesthesia

Published online by Cambridge University Press:  07 July 2006

T. Nishiyama
Affiliation:
The University of Tokyo, Faculty of Medicine, Department of Anesthesiology, Tokyo, Japan
S. Nakamura
Affiliation:
Tokyo Women's Medical University, Department of Anesthesiology, Shinjuku, Japan
K. Yamashita
Affiliation:
Kochi University Medical School, Department of Anesthesiology and Critical Care Medicine, Kochi, Japan
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Abstract

Summary

Background and objective: The best place for the electrode of transcutaneous measurement of oxygen tension (tcPO2) and carbon dioxide tension (tcPCO2) during general anaesthesia was investigated in three different locations. Methods: Fifteen patients for major abdominal surgery in the supine position were studied. The electrode of the TCM4 (Radiometer, Copenhagen, Denmark) was put on the chest, upper arm or forearm. TcPO2, tcPCO2, end-tidal carbon dioxide tension (etCO2), percutaneous oxygen saturation (SaO2), arterial oxygen tension (PaO2 ) and arterial carbon dioxide tension (PaCO2) were simultaneously measured at four different etCO2 concentrations and inhaled oxygen percentages and the location of the electrode was changed to other places to repeat the same measurement. In total, 12 measurements for each patient and 60 measurements for each place were performed. Results: TcPO2 correlated better than SaO2 (R2 = 0.58) with PaO2 (R2 = 0.76), and tcPCO2 correlated well with PaCO2 (R2 = 0.76) and etCO2 (R2 = 0.74) when the electrode was put on the chest, while not on the upper arm or forearm (R2 < 0.5). However, limits of agreement were too big to use tcPO2 (bias, −67.9; limits of agreement, 16.5, −152.3) and tcPCO2 (bias, −0.47; limits of agreement, 8.7, −9.64) as surrogate measures of PaO2 and PaCO2, respectively even when the electrode was put on the chest. Conclusions: When the electrode was put on the chest, tcPO2 and tcPCO2 might be available as non-invasive monitors of oxygenation and CO2 status during general anaesthesia, while the absolute values were not interchangeable with PaO2 and PaCO2, respectively.

Type
Original Article
Copyright
2006 European Society of Anaesthesiology

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References

Huch R, Huch A, Albani Met al. Transcutaneous PO2 monitoring in routine management of infants and children with cardiovascular problems. Pediatrics 1976; 57: 681690.Google Scholar
Hutchison DCS, Rocca G, Honeybourne D. Estimation of arterial oxygen tension in adult subjects using a transcutaneous electrode. Thorax 1981; 36: 473477.Google Scholar
Monaco F, McQuitty JC, Nickerson BG. Calibration of a heated transcutaneous carbon dioxide electrode to reflect arterial carbon dioxide. Am Rev Respir Dis 1983; 127: 322324.Google Scholar
Takiwaki H, Nakanishi H, Shono Y, Arase S. The influence of cutaneous factors on the transcutaneous pO2 and pCO2 at various body sites. Br J Dermatol 1991; 125: 243247.Google Scholar
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurements. Lancet 1986; 8476: 307310.Google Scholar
Steurer J, Hoffmann U, Dur P, Russi E, Vetter W. Changes in arterial and transcutaneous oxygen and carbon dioxide tensions during and after voluntary hyperventilation. Respiration 1997; 64: 200205.Google Scholar
Tremper KK, Shoemaker WC. Transcutaneous oxygen monitoring of critically ill adults, with and without low flow shock. Crit Care Med 1981; 9: 706709.Google Scholar
Janssens JP, Perrin E, Bennani I, de Muralt B, Titelion V, Picaud C. Is continuous transcutaneous monitoring of PCO2 (TcPCO2 ) over 8 h reliable in adults? Respir Med 2001; 95: 331335.Google Scholar
Wimberley PD, Pedersen KG, Thode J, Fogh-Anderson N, Sorensen AM, Siggaard-Anderson O. Transcutaneous and capillary pCO2 and pO2 measurements in healthy adults. Clin Chem 1983; 29: 14711473.Google Scholar
Clark JS, Votteri B, Ariagno RLet al. Noninvasive assessment of blood gases. Am Rev Respir Dis 1992; 145: 220232.Google Scholar
Janssens JP, Howarth-Frey C, Chevrolet JC, Abajo B, Rochet T. Transcutaneous PCO2 to monitor noninvasive mechanical ventilation in adults: assessment of a new transcutaneous device. Chest 1998; 113: 768773.Google Scholar
Palmisano BW, Sveringhaus JW. Transcutaneous PCO2 and PO2 : a multicenter study of accuracy. J Clin Monit 1990; 16: 844847.Google Scholar
Severinghaus JW. Transcutaneous blood gas analysis. Respir Care 1982; 27: 152159.Google Scholar
Tremper KK, Waxman K, Shoemaker WC. Effects of hypoxia and shock on transcutaneous PO2 values in dogs. Crit Care Med 1979; 7: 526531.Google Scholar
Bradley AF, Severinghaus JW, Stupfel M. Effect of temperature on PCO2 and PO2 of blood in vitro. J Appl Physiol 1956; 9: 201204.Google Scholar
Schachter EN, Rafferty TD, Knight Cet al. Transcutaneous oxygen and carbon dioxide monitoring. Use in adult surgical patients in an intensive care unit. Arch Surg 1981; 116: 11931196.Google Scholar
Rithalia SV, Rozkovec A, Tinker J. Characteristics of transcutaneous oxygen tension monitors in normal adults and critically ill patients. Intens Care Med 1979; 5: 147153.Google Scholar
Franklin ML. Transcutaneous measurement of partial pressure of oxygen and carbon dioxide. Respir Care Clin North Am 1995; 1: 119131.Google Scholar
Wimberley PD, Gronlund-Pedersen K, Olsson J, Siggaard-Abderson O. Transcutaneous carbon dioxide and oxygen tension measured at different temperatures in healthy adults. Clin Chem 1985; 31: 16111615.Google Scholar
McBride JrDS, Johnson JO, Tobias JD. Noninvasive carbon dioxide monitoring during neurosurgical procedures in adults: end-tidal versus transcutaneous techniques. South Med J 2002; 95: 870874.Google Scholar
Bhavani-Shankar K, Moseley H, Kumar AY, Delph Y. Capnometry and anesthesia. Can J Anaesth 1992; 39: 617632.Google Scholar
Reid CW, Martineau RJ, Miller DR, Hull KA, Baines J, Sullivan PJ. A comparison of transcutaneous, end-tidal and arterial measurements of carbon dioxide during general anesthesia. Can J Anaesth 1992; 39: 3136.Google Scholar
Berkenbosch JW, Lam J, Burd RS, Tobias JD. Noninvasive monitoring of carbon dioxide during mechanical ventilation in older children: end-tidal versus transcutaneous techniques. Anesth Analg 2001; 92: 14271231.Google Scholar