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Results for “Blood Gas Monitoring, Transcutaneous”

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At least 19 recordsLinked to original sources
PubMed2001

Transcutaneous blood gas monitoring in the rat.

Transcutaneous blood gas (TCBG) analysis is a noninvasive alternative method of estimation of blood gas tensions. The objective of the study reported here was to validate this method against standard blood gas (STBG) analysis in adult and juvenile Sprague-Dawley rats. We sought to establish the optimal TCBG probe site and temperature, to establish probe temperatures that would not cause thermal burns, to evaluate correlations between blood gas values (PaCO2 and PaO2) determined by use of TCBG and STBG, and to evaluate the sensitivity of the TCBG unit to changes in arterial blood gas partial pressures. Our results indicated that: in general, the xyphoid area was the optimal site for probe placement, with 44.5 degrees C being the optimal probe temperature for the highest correlation, but thermal burns may be a problem; probe temperatures of 42.5 degrees C (adults) and 42.0 degrees C (juveniles) do not cause thermal burns when left in place for three hours; probe temperatures of 44 degrees C (adults) and 42 degrees C (juveniles) resulted in moderate correlation between PaCO2 and PtcCO2; and the TCBG unit adequately responded to changes in arterial blood gas partial pressures. Neither PtcCO2 or PtcO2 reflect actual values of PaCO2 or PaO2, respectively. We concluded that TCBG analysis may be used as an indicator of change in PaCO2 with sufficient animal numbers under tightly controlled conditions, but not as an indicator of change in PaO2 in adult and juvenile rats.

Animals↗
PubMedDate not supplied

Developments in transcutaneous blood gas monitoring: a review.

Transcutaneous measurements of oxygen (tcPO2) and carbon dioxide (tcPCO2) are useful in the intensive care unit because they provide continuous and non-invasive estimation of arterial blood gases. In patients with compromised peripheral blood flow the cutaneous values will reflect the haemodynamic changes as blood is shunted away. They have been increasingly used in a variety of clinical situations, such as assessment of skin flap viability, drug evaluation, prediction of wound healing and selection of amputation level in peripheral vascular disease. From a review of available literature it appears that transcutaneous monitors have found another application as indicator of local tissue perfusion.

Animals↗
PubMed2005

A survey of transcutaneous blood gas monitoring among European neonatal intensive care units.

BACKGROUND: PCO2 and PO2 are important monitoring parameters in neonatal intensive care units (NICU). Compared to conventional blood gas measurements that cause significant blood loss in preterms, transcutaneous (tc) measurements allow continuous, non-invasive monitoring of blood gas levels. The aim of the study was to survey the usage and opinions among German speaking NICUs concerning tc blood gas monitoring. METHODS: A questionnaire was developed and sent to 56 head nurses of different NICUs in Germany, Switzerland and Austria. RESULTS: A completely answered questionnaire was obtained from 41 NICUs. In two of these units tc measurements are not performed. In most NICUs (77%), both PtcO2 and PtcCO2 are measured simultaneously. Most units change the sensors every 3 hours; however, the recommended temperature of 44 degrees C is used in only 15% of units. In only 8% of units are arterial blood gases obtained to validate tc values. Large variations were found concerning the targeted level of oxygen saturation [median upper limit: 95% (range 80-100%); median lower limit: 86% (range 75-93%)] and PO2 [median upper limit: 70 mmHg (range 45-90 mmHg); median lower limit: 44 mmHg (range 30-60 mmHg)]. CONCLUSION: Our survey shows that the use of tc monitors remains widespread among German speaking NICUs, despite earlier data suggesting that their use had been abandoned in many NICUs worldwide. In addition, we suggest that the current method of monitoring oxygenation may not prevent hyperoxemia in preterm infants.

Austria↗
PubMed1988

[Value of transcutaneous blood gas monitoring in fiberoptic bronchoscopy in intensive care patients].

Transcutaneous carbon dioxide and oxygen tensions (PtcCO2 and PtcO2) were monitored in seven critically ill patients under mechanical ventilation during fiberoptic bronchoscopy. In these conditions, both PtcO2 and PaO2 and PtcCO2 and PaCO2 correlated, with correlation coefficients of 0.964 and 0.793 respectively. Fiberoptic bronchoscopy induced an average fall in PtcO2 of 42 +/- 2.57 mmHg and an average increase in PtcCO2 of 12.1 +/- 1.89 mmHg; these two parameters returned quickly to their initial values after the procedure. Holter monitoring showed an arrhythmia in five of the seven patients. Continuous measurement of PtcO2 and PtcCO2 was a safe and reliable method for monitoring mechanically ventilated patients undergoing fiberoptic bronchoscopy.

Aged↗
PubMed1992

Transcutaneous blood gas monitoring during salbutamol inhalations in young children with acute asthmatic symptoms.

The effect of salbutamol inhalations on transcutaneous blood gases was investigated in 23 children (aged 11 months-2.5 years) with asthmatic symptoms. After one salbutamol inhalation there was a mean increase in transcutaneous PO2 (tcPO2) of 0.5 kPa (P less than 0.01); after a second dose given 30 minutes later, the mean increase was 1.2 kPa (P less than 0.001). The increase in tcPO2 after only one dose of salbutamol was significantly correlated to age (P less than 0.01). No such correlation was observed after a second dose. The overall increase in tcPO2 after two salbutamol inhalations showed a negative correlation to the duration of the current symptomatic period (P less than 0.05). We conclude that salbutamol inhalations have beneficial effects in young children with acute asthmatic symptoms, even below the age of 18 months, provided that an adequate dose reaches the lung and preferably at an early stage of obstruction.

Acute Disease↗
PubMedDate not supplied

Transcutaneous blood gas monitoring during peritoneal dialysis in the neonate.

Transcutaneous oxygen and carbon dioxide were monitored continuously during peritoneal dialysis in an infant with severe idiopathic respiratory distress syndrome requiring mechanical ventilation. These showed marked changes in blood gases occurring in phase with the cycles of dialysis due to interference with ventilatory function by fluid in the peritoneal cavity. This finding has important implications for the management of infants requiring peritoneal dialysis during mechanical ventilation.

Acute Kidney Injury↗
PubMed1988

Chest physiotherapy. Evaluation by transcutaneous blood gas monitoring.

Two respiratory physiotherapy methods were evaluated by analyzing changes in the transcutaneous partial pressure of CO2 (tcPCO2) in 15 patients with respiratory insufficiency. All were receiving continuous oxygen therapy and had CO2 retention. The physiotherapy methods compared were thoracic compression (TC) and positive expiratory pressure (PEP). The mean decrease (+/- SD) in tcPCO2 was the same with both methods, 0.6 +/- 0.4 kPa, but there were interindividual differences. This study indicates that both TC and PEP effectively decrease tcPCO2, although only temporarily in many cases. Continuous tcPCO2 monitoring is a useful clinical method for determining and teaching optimal respiratory therapy.

Aged↗
PubMed2004

Chronic venous insufficiency of the lower limbs: suitability of transcutaneous blood gas monitoring as an endpoint to evaluate the outcome of pharmacological treatment with calcium dobesilate.

This pilot clinical trial was designed to further investigate the effects of calcium dobesilate in the treatment of chronic venous insufficiency (CVI) by means of a novel endpoint, transcutaneous oxygen pressure (TcPO2), and to evaluate the suitability of this endpoint for future research. Patients with mild to moderate CVI without active ulcers were randomized to receive calcium dobesilate 1000 mg/day, 2000 mg/day or placebo for 12 weeks. The primary efficacy endpoint was TcPO2 in the distal third of the internal side of the leg. Secondary endpoints included assessment of venous reflux and clinical symptoms. Patients in the dobesilate 1000 mg/day and placebo groups showed a mild increase in TcPO2 (adjusted mean change 2.67 mmHg and 1.56 mmHg, respectively), while those treated with 2000 mg/day of the active drug showed a decrease (adjusted mean change -0.53 mmHg). Conversely, clinical symptoms and venous reflux improved in all groups, especially with dobesilate, but differences with placebo were not significant. Treatment was very well tolerated. Although the absence of significant differences prevented confirmation of sensitivity, a trend favoring calcium dobesilate in clinical and hemodynamic parameters was observed. This improvement was not reflected by TcPO2.

Adolescent↗
PubMed1978

Safe and effective use of transcutaneous blood gas monitors.

The Medical Devices Amendments of 1976 (PL 94-295) will compel users of transcutaneous monitors to comply with Class II, Performance Standards. These standards will have to provide reasonable assurance of the safety and effectiveness of the device. Similar standards are in preparation for other cardiac and respiratory monitors. Dangers of tcPO2 monitors include shock and burn, which requires attention to the insulation of the monitor from the power line and from recorders used to record the output. Optimal safe time vs. temperature limits have not yet used to record to output. Optimal safe time vs. temperature limits have not yet been established, and these may vary with age, skin site, blood pressure and body and environmental temperature. The usefulness of alarms for PO2, sensor temperature and heating power, and their limits remain ot be defined by extensive clinical use. Standards for drift, reproducibility, recalibration interval and accuracy will have to be set after more extensive clinical use especially by groups not involved in the initial prototype development and testing. In order to prove that these devices are also effective, physicians will have to document that care would have been different, and might have impaired patient safety, if the device had not been used.

Blood Gas Analysis↗
PubMed1983

[Continuous transcutaneous blood gas monitoring during fiberbronchoscopy].

In 28 patients PO2 and PCO2 were measured continuously during diagnostic fiberbronchoscopy by means of transcutaneous electrodes (PtcO2 and Ptc CO2 System TCM Radiometer Copenhagen). A mean decrease in PtcO2 of 31% (s +/- 16.5%) was found. This effect can be prohibited by using oxygen insufflation at a rate of 0.5 liters per minute by nasal tube. The positive effect of fiberbronchoscopic lavage in cases of severe dyscrinism is documented. A mean increase in PtcO2 of 42% was found after the procedure, but there is a time lag of 20-30 minutes until the maximal increase is reached. In patients with known but not acute bronchial asthma the irritation of the bronchial system by fiberbronchoscopy induces a histamine release. There is no relation between the release of histamine and the decrease in arterial oxygen tension.

Adult↗
PubMed2006

Transcutaneous blood gas CO2 monitoring of induced ventilatory depression in mice.

We assessed a simple, noninvasive method of monitoring transcutaneous partial pressure of CO2 (Ptcco2) in mice to determine whether it would provide an accurate and reproducible method to assess ventilatory depression in mice. To this end, Ptcco2 and Paco2 (partial pressure of arterial CO2) measurements were performed on isoflurane-anesthetized male C57Bl/6 mice breathing differing percentages of CO2 or fentanyl, a known ventilatory depressive drug. All doses of fentanyl produced a sharp increase in Ptcco2 values within 20 min with difference in Ptcco2 values between saline and all fentanyl groups being statistically significant (P < 0.0001). A good correlation between Paco2 and Ptcco2 values was established (r2 = 0.91). A Bland-Altman analysis likewise found that Ptcco2 measurements in the mice reliably and accurately reflected their Paco2 values. Therefore, under controlled conditions, Ptcco2 measurements were found to reliably reflect Paco2 values in mice. Consequently, the Ptcco2 method can be used as a means to rapidly and quantitatively assess the ventilatory depressive properties of a wide spectrum of drugs, under varying conditions in numerous mouse models.

Anesthetics, Inhalation↗
PubMed1988

Transcutaneous monitoring of blood gas tensions in patients on intermittent peritoneal dialysis.

A relative contraindication to intermittent peritoneal dialysis (IPD) is chronic lung disease. To evaluate whether the instillation of 2 L of fluid into the peritoneal cavity affects respiratory function, five IPD patients were studied in the supine position during the first 4 h of a routine IPD session. Blood gas tensions were monitored transcutaneously throughout the study period. At the onset of dialysis, mean transcutaneous blood oxygen tension (PtcO2) was 70.6 +/- 9.1 mm Hg. It decreased to 55 +/- 9.9 mm Hg (22% change from basal values) during the instillation of dialysate. Upon drainage, PtcO2 returned to baseline. This sequence of events repeated itself on subsequent exchanges, although with decreasing decrements of PtcO2 with each consecutive exchange (decrease to 58.6 +/- 7.05, 61 +/- 6.5, 63.8 +/- 5.2 mm Hg corresponding to 16%, 12.7%, and 9.6%, respectively, during the second to fourth exchanges). Transcutaneous blood carbon dioxide tension, PtcCO2, showed a very mild increase during the study (33 +/- 7.1 to 38 +/- 6.0 mm Hg). In two patients, the same study protocol was performed during the last 4 h of an IPD session. In these two patients, there was only a 5% variation of PtcO2 from baseline values. These results suggest that an adaptive response to the hypoxemia induced by dialysate instillation rapidly occurs in IPD patients.

Adult↗
PubMed1994

Is transcutaneous PO2 monitoring during exercise a reliable alternative to arterial PO2 measurements?

Arterial PO2 measurement during exercise is an important part in the evaluation of pulmonary disease but requires an intra-arterial cannula. However, in clinical work it would be preferable to assess PO2 non-invasively. To evaluate such a technique, simultaneous measurements of transcutaneous PO2 (tcPO2) and arterial PO2 (PaO2), sampled from an indwelling arterial radial cannula, were made before, during and after a fatigue or symptom-limited bicycle exercise test in 16 patients referred to hospital because of dyspnoea. In total 181 paired measurements were made. Mean values (range) of PaO2 and tcPO2 were 11.2 kPa (5-16) and 9.5 (5-13.3), respectively. The correlation coefficient between PaO2 and TcPO2 was only 0.36 (P < 10(-5)). By normalizing the values of tcPO2 and PaO2 to corresponding values at supine rest before exercise, the correlation coefficient increased to 0.80 (P < 10(-6). Using PaO2 as golden standard, tcPO2 described the trend in pO2 during exercise reasonably well in all cases and this information is often sufficient for assessing the degree of pulmonary insufficiency. Thus, transcutaneous blood gas monitoring during exercise is useful for clinical evaluation of pulmonary disease, but a single arterial blood sample at rest before exercise is recommended for baseline correlation.

Aged↗
PubMed1995

Ventilatory and gas exchange abnormalities on exercise in chronic heart failure.

The mechanism of breathlessness on exertion in patients with chronic heart failure are still not fully understood. We therefore investigated the effects of ventilatory and gas exchange abnormalities on exercise capacity in chronic heart failure. Exercise testing was performed in 30 patients with exertional breathlessness due to chronic heart failure and in 30 controls, using continuous transcutaneous blood gas monitoring. Maximal symptom-limited oxygen consumption as (V'O2) as a percentage predicted was reduced in patients (45 +/- 10%; mean +/- SD) compared to controls (87 +/- 7). The ventilatory response (minute ventilation/carbon dioxide production (V'E/V'CO2)) was significantly increased in patients compared to controls (39.9 +/- 7.7 and 25.9 +/- 3.6, respectively). The dead space to tidal volume ratio (VD/VT) was raised in patients compared to controls at rest (0.45 +/- 0.04 vs 0.35 +/- 0.02, respectively) and this persisted on exertion (0.40 +/- 0.05 in patients and 0.20 +/- 0.05 in controls). At maximal symptom-limited exercise, V'E/V'CO2 was inversely related to the % predicted V'O2 in patients, but not in controls (r = -0.62 and r = -0.24, respectively). In patients, V'E/V'CO2 was significantly correlated with VD/VT at maximum exercise (r = 0.82). Patients with chronic heart failure have a significant degree of "wasted ventilation" on exertion, which is associated with increased ventilatory response. The increased ventilatory response on exertion appears to contribute to exercise limitation in these patients.

Adult↗
PubMed1992

Transcutaneous and arterial blood gas monitoring during acute asthmatic symptoms in older children.

The relationship between transcutaneous and arterial blood gases was investigated in 14 children with asthmatic symptoms, aged 7-15 years, before and after the inhalation of salbutamol. The degree of bronchial obstruction was assessed by forced expiratory volume in one second (FEV1) and maximum expiratory flow when 25% of FVC remained to be expelled (MEF25). On average the transcutaneous PO2 (tcPO2) was 1.3 kPa (range, 2.6-0 kPa) lower and the transcutaneous PCO2 was 0.6 kPa (range, 0-1.5 kPa) higher than the corresponding arterial values (P less than 0.01). The difference between arterial and transcutaneous PO2 was the same over the whole range of values studied (7.5-14 kPa). After the inhalation of salbutamol, the relationship between transcutaneous and arterial blood gases was not significantly changed. Changes in transcutaneous PO2 correlated to changes in MEF25 (P less than 0.05), indicating a common denominator, probably the conditions in the peripheral airways. We conclude that the close relationship between transcutaneous and arterial blood gases, even after the inhalation of a beta-2 agonist, indicates that the transcutaneous technique can be used for monitoring acute bronchial obstruction and for evaluating the effects of treatment in children of different ages.

Acute Disease↗