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Longtime performance and reliability of two different PtcCO 2 and SpO 2 sensors in neonates
Author(s) -
BERNET VERA,
DÖLL CARSTEN,
CANNIZZARO VINCENZO,
ERSCH JÖRG,
FREY BERNHARD,
WEISS MARKUS
Publication year - 2008
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2008.02661.x
Subject(s) - medicine , pulse oximetry , critically ill , capnography , anesthesia , arterial blood , blood gas analysis , limits of agreement , oxygen saturation , pco2 , nuclear medicine , oxygen , chemistry , organic chemistry
Summary Objectives: Blood gas monitoring is necessary in treatment of critically ill neonates. Whereas SaO 2 can be estimated by pulse oximetry, PaCO 2 is still most often assessed from blood samples. Aim: To compare long time performance of an ear sensor for combined assessment of transcutaneous carbon dioxide (PtcCO 2 ) and oxygen saturation (SpO 2 ) (TOSCA Monitor; Radiometer, Switzerland) with a conventional PtcCO 2 monitor (MicroGas 7650‐500 rapid, Radiometer, Switzerland) in critically ill neonates. Methods: Prospective, observational study. Twenty critically ill neonates were monitored for PtcCO 2 and SpO 2 using the Tosca and the MicroGas monitor for 24 h. TOSCA ear sensor was changed to the other ear lobe after 12 h and the MicroGas sensor four hourly on the trunk. Values obtained were compared with SaO 2 and PaCO 2 from arterial blood gas analysis using Bland–Altman analysis. Data are presented as median (range). Results: Eighty‐two paired measurements were obtained. Median age of the 20 patients was 4.5 days (1–26 days) and weight was 3.05 kg (0.98–3.95 kg). Bias and precision between PaCO 2 and PtcCO 2 were 0.14 and 1.45 kPa for the Tosca monitor and −0.08 and 1.2 kPa for the MicroGas monitor, respectively. The two biases were significantly different ( P = 0.0036). SpO 2 assessment by TOSCA was comparable to SaO 2 values (bias 0.26% and precision 4.14%). Conclusion : The TOSCA monitor allows safe estimation of PtcCO 2 and SaO 2 in neonates. Measurements of PtcCO 2 were less reliable with TOSCA compared with conventional monitoring but still allow assessing a trend of ventilation status in newborn patients.