Accuracy of transcutaneous carbon dioxide monitoring in hypotensive patients

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Abstract

Objectives: Continuous blood gas monitoring is frequently necessary in critically ill patients. Our aim was to assess the accuracy of transcutaneous CO2 tension (PtcCO2) monitoring in the emergency department (ED) assessment of hypotensive patients by comparing it with the gold standard of arterial blood gas analysis (ABGA). Methods: All patients receiving PtcCO2 monitoring in the ED were included. We excluded paediatric patients, patients with no ABGA results during a hypotensive event, patients whose ABGA was not performed simultaneously with PtcCO2 monitoring, and patients who received sodium bicarbonate for resuscitation. The included patients were classified into hypotensive patients and normotensive patients. A hypotensive patient was defined as a patient showing a mean arterial pressure under 60 mm Hg. The agreement in measurement between PaCO2 tension (PaCO2) and PtcCO2 were investigated in both groups. Results: The mean difference between PaCO2 and PtcCO2 was 2.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -15.6 to 19.7 mm Hg in the 28 normotensive patients. The mean difference between PaCO2 and PtcCO2 was 1.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -19.5 to 21.7 mm Hg in the 26 hypotensive patients. The weighted κ values were 0.64 in the normotensive patients and 0.60 in the hypotensive patients. Conclusions: PtcCO2 monitoring showed wider limits of agreement with PaCO 2 in urgent situations in the ED environment. However, acutely developed hypotension does not affect the accuracy of PtcCO2 monitoring.

Original languageEnglish
Pages (from-to)323-326
Number of pages4
JournalEmergency Medicine Journal
Volume31
Issue number4
DOIs
Publication statusPublished - 2014 Jan 1

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Carbon Dioxide
Blood Gas Analysis
Hospital Emergency Service
Sodium Bicarbonate
Physiologic Monitoring
Critical Illness
Resuscitation
Hypotension
Arterial Pressure
Gases

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

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title = "Accuracy of transcutaneous carbon dioxide monitoring in hypotensive patients",
abstract = "Objectives: Continuous blood gas monitoring is frequently necessary in critically ill patients. Our aim was to assess the accuracy of transcutaneous CO2 tension (PtcCO2) monitoring in the emergency department (ED) assessment of hypotensive patients by comparing it with the gold standard of arterial blood gas analysis (ABGA). Methods: All patients receiving PtcCO2 monitoring in the ED were included. We excluded paediatric patients, patients with no ABGA results during a hypotensive event, patients whose ABGA was not performed simultaneously with PtcCO2 monitoring, and patients who received sodium bicarbonate for resuscitation. The included patients were classified into hypotensive patients and normotensive patients. A hypotensive patient was defined as a patient showing a mean arterial pressure under 60 mm Hg. The agreement in measurement between PaCO2 tension (PaCO2) and PtcCO2 were investigated in both groups. Results: The mean difference between PaCO2 and PtcCO2 was 2.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -15.6 to 19.7 mm Hg in the 28 normotensive patients. The mean difference between PaCO2 and PtcCO2 was 1.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -19.5 to 21.7 mm Hg in the 26 hypotensive patients. The weighted κ values were 0.64 in the normotensive patients and 0.60 in the hypotensive patients. Conclusions: PtcCO2 monitoring showed wider limits of agreement with PaCO 2 in urgent situations in the ED environment. However, acutely developed hypotension does not affect the accuracy of PtcCO2 monitoring.",
author = "Jung-Youn Kim and Young-Hoon Yoon and Lee, {Sung Woo} and Choi, {Sung Hyuk} and Cho, {Young Duck} and Park, {Sang Min}",
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T1 - Accuracy of transcutaneous carbon dioxide monitoring in hypotensive patients

AU - Kim, Jung-Youn

AU - Yoon, Young-Hoon

AU - Lee, Sung Woo

AU - Choi, Sung Hyuk

AU - Cho, Young Duck

AU - Park, Sang Min

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objectives: Continuous blood gas monitoring is frequently necessary in critically ill patients. Our aim was to assess the accuracy of transcutaneous CO2 tension (PtcCO2) monitoring in the emergency department (ED) assessment of hypotensive patients by comparing it with the gold standard of arterial blood gas analysis (ABGA). Methods: All patients receiving PtcCO2 monitoring in the ED were included. We excluded paediatric patients, patients with no ABGA results during a hypotensive event, patients whose ABGA was not performed simultaneously with PtcCO2 monitoring, and patients who received sodium bicarbonate for resuscitation. The included patients were classified into hypotensive patients and normotensive patients. A hypotensive patient was defined as a patient showing a mean arterial pressure under 60 mm Hg. The agreement in measurement between PaCO2 tension (PaCO2) and PtcCO2 were investigated in both groups. Results: The mean difference between PaCO2 and PtcCO2 was 2.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -15.6 to 19.7 mm Hg in the 28 normotensive patients. The mean difference between PaCO2 and PtcCO2 was 1.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -19.5 to 21.7 mm Hg in the 26 hypotensive patients. The weighted κ values were 0.64 in the normotensive patients and 0.60 in the hypotensive patients. Conclusions: PtcCO2 monitoring showed wider limits of agreement with PaCO 2 in urgent situations in the ED environment. However, acutely developed hypotension does not affect the accuracy of PtcCO2 monitoring.

AB - Objectives: Continuous blood gas monitoring is frequently necessary in critically ill patients. Our aim was to assess the accuracy of transcutaneous CO2 tension (PtcCO2) monitoring in the emergency department (ED) assessment of hypotensive patients by comparing it with the gold standard of arterial blood gas analysis (ABGA). Methods: All patients receiving PtcCO2 monitoring in the ED were included. We excluded paediatric patients, patients with no ABGA results during a hypotensive event, patients whose ABGA was not performed simultaneously with PtcCO2 monitoring, and patients who received sodium bicarbonate for resuscitation. The included patients were classified into hypotensive patients and normotensive patients. A hypotensive patient was defined as a patient showing a mean arterial pressure under 60 mm Hg. The agreement in measurement between PaCO2 tension (PaCO2) and PtcCO2 were investigated in both groups. Results: The mean difference between PaCO2 and PtcCO2 was 2.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -15.6 to 19.7 mm Hg in the 28 normotensive patients. The mean difference between PaCO2 and PtcCO2 was 1.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from -19.5 to 21.7 mm Hg in the 26 hypotensive patients. The weighted κ values were 0.64 in the normotensive patients and 0.60 in the hypotensive patients. Conclusions: PtcCO2 monitoring showed wider limits of agreement with PaCO 2 in urgent situations in the ED environment. However, acutely developed hypotension does not affect the accuracy of PtcCO2 monitoring.

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U2 - 10.1136/emermed-2012-202228

DO - 10.1136/emermed-2012-202228

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JO - Emergency Medicine Journal

JF - Emergency Medicine Journal

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