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Clinical Investigations in Critical CareTranscutaneous Pco2 to Monitor Noninvasive Mechanical Ventilation in Adults: Assessment of a New Transcutaneous Pco2 Device
Section snippets
Materials and Methods
The study protocol was approved by the Ethics Committee of the University Hospital of Geneva. Patients who had been admitted in the ICU and equipped with an indwelling arterial catheter were considered for the present study. To be included, they had to be in hemodynamically stable condition without vasopressor amine treatment other than low-dose dopamine (≤0.2 mg/min) to avoid cutaneous hypoperfusion or vasoconstriction. Twenty-six patients were included (18 men, 8 women, aged 68±10 years).
Results
Agreement between transcutaneous and arterial values for CO2 was tested over a range of 26 to 71 mm Hg. TcPco2 as a function of PaCO2 is shown on Figure 2. Both measurements were highly correlated (r=0.968, p<0.001), and linear regression was close to the identity line (TcPco2=1.116×PaCO2—0.46). Figure 2 indicates that at high Pco2 values, there was a trend for TcPco2 to slightly overestimate PaCO2. Figure 3 shows the d and limits of agreement between the TcPco2 and PaCO2. The d was 0.75 mm Hg;
Discussion
We have shown that TcPco2 values, measured with the capnograph (Fastrac), showed a good agreement with simultaneous arterial measurements of PaCO2, without significant drift after 4 h of continuous recording.
A review of published studies, as summarized in Table 1, shows conflicting results regarding agreement between TcPco2 and PaCO2.3,7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 Five studies, however, gave excellent correlation, two of them7, 11 indicating Pearson's coefficient of correlation (r)
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