Stege Gerben, van den Elshout Frank J J, Heijdra Yvonne F, van de Ven Marjo J T, Dekhuijzen P N Richard, Vos Petra J E
Department of Pulmonology, Rijnstate Hospital, NL-6800 TA Arnhem, The Netherlands.
Respiration. 2009;78(2):147-53. doi: 10.1159/000187631. Epub 2008 Dec 17.
Measurements of transcutaneous carbon dioxide tension (PtcCO(2)) with current devices are proven to provide clinically acceptable agreement with measurements of partial arterial carbon dioxide tension (PaCO(2)) in several settings but not during cardiopulmonary exercise testing (CPET).
The primary objective of this study was to investigate the agreement between PaCO(2) and PtcCO(2) measurements (using a Tosca 500 with a Tosca sensor 92) during CPET. A secondary objective was to investigate the agreement between arterial and transcutaneous oxygen saturation (SaO(2), SpO(2)) as measured with this sensor during CPET.
In patients with various pulmonary diseases, PtcCO(2) and SpO(2) were continuously measured and compared with arterial blood gas samples during CPET. A maximum bias of 0.5 kPa and 95% limits of agreement (LOA) of 1 kPa between carbon dioxide pressure (PCO(2)) measurements were determined as clinically acceptable.
In total 101 'paired' arterial and transcutaneous measurements were obtained from 21 patients. Bias between PaCO(2) and PtcCO(2) was -0.03 kPa with LOA from -0.78 to 0.71 kPa. Bias between SaO(2) and SpO(2) was -1.0% with LOA from -2.83 to 0.83%.
Transcutaneous estimations of PCO(2) and SpO(2) are accurate and can be used in CPET, circumvening the need for arterial cannulation.
目前的设备所测量的经皮二氧化碳分压(PtcCO₂)已被证明在多种情况下与动脉血二氧化碳分压(PaCO₂)的测量结果具有临床可接受的一致性,但在心肺运动试验(CPET)期间并非如此。
本研究的主要目的是调查CPET期间PaCO₂与PtcCO₂测量值(使用配备Tosca传感器92的Tosca 500)之间的一致性。次要目的是调查CPET期间使用该传感器测量的动脉血氧饱和度(SaO₂)与经皮血氧饱和度(SpO₂)之间的一致性。
在患有各种肺部疾病的患者中,在CPET期间连续测量PtcCO₂和SpO₂,并与动脉血气样本进行比较。将二氧化碳分压(PCO₂)测量值之间的最大偏差0.5 kPa和95%一致性界限(LOA)1 kPa确定为临床可接受。
共从21例患者中获得了101对“配对”的动脉和经皮测量值。PaCO₂与PtcCO₂之间的偏差为-0.03 kPa,LOA为-0.78至0.71 kPa。SaO₂与SpO₂之间的偏差为-1.0%,LOA为-2.83至0.83%。
PCO₂和SpO₂的经皮估计值是准确的,可用于CPET,无需进行动脉插管。