J Clin Monit Comput - Comparison of ear and chest probes in transcutaneous carbon dioxide pressure measurements during general anesthesia in adults.


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JECTIVE: For transcutaneous carbon dioxide pressure (tcPCO(2)) measurement, the probe on the trunk or extremities has been used for many years. Our previous study showed that chest was better than arm for tcPCO(2) monitoring. Recently, the ear probe has been developed. The accuracy of tcPCO(2) as a surrogate measurement of arterial carbon dioxide pressure (PaCO(2)) has not been compared between the measurement with probe on the chest and measurement with probe on the earlobe. This study compared the accuracy of tcPCO(2) measured on the chest and tcPCO(2) measured on earlobe during general anesthesia in adults using linear regression analysis and Bland-Altman plot.METHODS: Ten patients aged 30-70?years scheduled for abdominal surgery under general anesthesia were enrolled. TcPCO(2) by TCM4? (Radiometer, Copenhagen, Denmark, TtcPCO(2)) with its probe on the chest, tcPCO(2) by Sentec? (Sentec AG, Therwil, Switzerland, StcPCO(2)) with ear probe, end-tidal carbon dioxide pressure (EtCO(2)), and PaCO(2) were simultaneously measured at four different sets of EtCO(2) levels in each patient. In total, 40 measurements were performed. The Scatter plot and Bland-Altman plot were obtained. Correlation coefficient (R(2)) =0.70 and limits of agreement =4?mmHg were judged as significant.RESULTS: TtcPCO(2) showed significant positive correlation with PaCO(2) (R(2)?=?0.80) but StcPCO(2) did not (R(2)?=?0.55). TtcPCO(2) and PaCO(2), and StcPCO(2) and PaCO(2) had large limits of agreement (-6.56?mmHg, 4.21?mmHg and -11.05?mmHg, 7.64?mmHg, respectively). TtcPCO(2) and StcPCO(2) had no significant correlation (R(2)?=?0.63) and large limits of agreement (-8.98?mmHg to 7.91?mmHg).CONCLUSION: During general anesthesia in adults, both TtcPCO(2) and StcPCO(2) were not interchangeable with PaCO(2), but only TtcPCO(2) had good positive correlation with PaCO(2).

Resumo Limpo

jectiv transcutan carbon dioxid pressur tcpco measur probe trunk extrem use mani year previous studi show chest better arm tcpco monitor recent ear probe develop accuraci tcpco surrog measur arteri carbon dioxid pressur paco compar measur probe chest measur probe earlob studi compar accuraci tcpco measur chest tcpco measur earlob general anesthesia adult use linear regress analysi blandaltman plotmethod ten patient age year schedul abdomin surgeri general anesthesia enrol tcpco tcm radiomet copenhagen denmark ttcpco probe chest tcpco sentec sentec ag therwil switzerland stcpco ear probe endtid carbon dioxid pressur etco paco simultan measur four differ set etco level patient total measur perform scatter plot blandaltman plot obtain correl coeffici r limit agreement mmhg judg significantresult ttcpco show signific posit correl paco r stcpco r ttcpco paco stcpco paco larg limit agreement mmhg mmhg mmhg mmhg respect ttcpco stcpco signific correl r larg limit agreement mmhg mmhgconclus general anesthesia adult ttcpco stcpco interchang paco ttcpco good posit correl paco

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