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Abstract
BACKGROUND: Transcutaneous measurements of CO2 and O2 (
, 
) 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 transcutaneous 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 
versus 
and versus 
, and for changes in transcutaneous measurements between 2 time points (
and 
). 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 
and 
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 
and 
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: 
and 
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 period was acceptable, however, and transcutaneous monitoring may be used for continuous monitoring of 
in conjunction with arterial blood gas analysis for reference.
- transcutaneous blood gas monitoring
- noninvasive ventilation
- COPD
- hypercapnia
- respiratory insufficiency
- intensive care
Footnotes
- Correspondence: Christian S Meyhoff MD PhD, Bispebjerg Bakke 23, 2400 Copenhagen, NV, Denmark. E-mail: christian.sylvest.meyhoff{at}regionh.dk
Mr Sørensen and Dr Leicht are co-first authors.
Drs Aasvang and Meyhoff are joint senior authors.
Supplementary material related to this paper is available at http://www.rcjournal.com.
This work was supported in part by the Innovation Fund Denmark (8056-00055B); the Danish Cancer Society (R150-A9865-16-S48); Copenhagen Center for Health Technology (CACHET); Radiometer; A.P. Møller Foundation; Bispebjerg and Frederiksberg Hospital; Rigshospitalet; and the Technical University of Denmark. The WARD-project has received grants from the Innovation Fund Denmark, the Novo Nordic Foundation, the Danish Cancer Society, Steno Diabetes Center Denmark, Copenhagen Center for Health Technology, Radiometer, A.P. Møller Foundation as well as internal institutional funding. Drs Meyhoff and Aasvang are co-founders of a start-up company, WARD247 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD-project. WARD247 ApS has finalized terms for license agreement for any WARD-project software and patents. There are currently no patents pending or filed. None of the above entities have influence on the study design, conduct, analysis or reporting.
Dr Meyhoff discloses relationships with Merck Sharp & Dohme, Boehringer Ingelheim, and Radiometer. Dr Aasvang discloses relationships with Norpharma A/S and Radiometer. Dr Elvekjaer discloses a relationship with Merck Sharp & Dohme. The remaining authors have no conflicts to disclose.
- Copyright © 2021 by Daedalus Enterprises
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