Abstract
This study was designed to assess the accuracy of end-tidalPco 2 and transcutaneousPco 2 as measurements of arterialPco 2 in extubated, spontaneously breathing patients recovering from general anesthesia. In 30 patients, measurement of arterial transcutaneous, and end-tidalPco 2 were taken simultaneously with body temperature approximately every 15 minutes over a 2-hour period. ArterialPco 2 values were corrected for body temperature. Values for Paco 2 were compared with those forPetCO2 and Psco 2 by linear regression analysis and by calculation of bias ± precision. Thirty-six percent of the capnogram tracings obtained did not develop a plateau phase. We found poor correlation between end-tidal and arterialPco 2 regardless of the shape of the capnogram tracing, as well as poor correlation between transcutaneous and arterialPco 2. Although the measurements of bias and precision of noninvasivePco 2 monitors in this population are comparable to studies in other populations, we advise caution in relying on the routine use ofPetCO2 or Psco 2 for the noninvasive assessment of respiratory depression in extubated, spontaneously breathing patients recovering from general anesthesia.
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References
Knill RL, Gelb AW. Ventilatory response to hypoxia and hypercapnia during halothane sedation and anesthesia in man. Anesthesiology 1978;49:244–251
Nunn JF. Applied respiratory physiology. London: Butterworth, 1987:357–366
Monaco F, McQuitty JC, Nickerson BG. Calibration of a heated transcutaneous carbon dioxide electrode to reflect arterial carbon dioxide. Am Rev Respir Dis 1983;127:322–324
Bergman NA. Temperature coefficients for PCO2 and PO2 in bloods with varying acid-base status.J Appl Physiol 1968;24:225–228
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307–310
Tremper KK, Shoemaker WC, Shippy CR, et al. Transcutaneous PCO2 monitoring on adult patients in the ICU and the operating room. Crit Care Med 1981;9:752–755
Brambilla I, Micallef E, Sacerdoti C, et al. Value of nocturnal monitoring of transcutaneous O2 and CO2 pressures in adults with respiratory failure. Respiration 1985;48:81–90
Rafferty TD, Marrero O, Nardi D, et al. Relationship between transcutaneous and arterial carbon dioxide tension in adult patients anesthetized with nitrous oxidefentanyl and nitrous oxide-enflurane. Anesth Analg 1981;60:504–507
Brunner JX, Westenskow DR. How the rise time of carbon dioxide analyzers influences the accuracy of carbon dioxide measurements. Br J Anaesth 1988;61:628–638
Shankar KB, Moseley H, Kumar Y. Negative arterial to end-tidal gradients. Can J Anaesth 1991;38:260–261
Phan CQ, Tremper KK, Lee SE, et al. Non-invasive monitoring of carbon dioxide: A comparison of the partial pressure of transcutaneous and end-tidal carbon dioxide with the partial pressure of arterial carbon dioxide. J Clin Monit 1987;3:149–154
Fletcher R, Jonson B, Cumming G, et al. The concept of deadspace with special reference to the single breath test for carbon dioxide. Br J Anaesth 1981;53:77–87
Hoffman RA, Krieger BP, Kramer MR, et al. End-tidal carbon dioxide in critically ill patients during changes in mechanical ventilation. Am Rev Respir Dis 1989;140:1265–1268
Jones NL, Robertson DG, Kane JW. Differences between end-tidal and arterial CO2 in exercise. J Appl Physiol 1979;47:954–960
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Kavanagh, B.P., Sandler, A.N., Turner, K.E. et al. Use of end-tidalPco 2 and transcutaneousPco 2 as noninvasive measurement of arterialPco 2 in extubated patients recovering from general anesthesia. J Clin Monitor Comput 8, 226–230 (1992). https://doi.org/10.1007/BF01616780
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DOI: https://doi.org/10.1007/BF01616780