Département d'Accueil et de Traitement des Urgences, CHU de Caen, 14000 Caen, France.
Intensive Care Med. 2011 Feb;37(2):348-51. doi: 10.1007/s00134-010-2076-1. Epub 2010 Nov 11.
Transcutaneous CO(2) monitors are widely used in neonatal ICUs. Until recently, these devices performed poorly in adults. Recent technical modifications have produced transcutaneous CO(2) monitors that have performed well in adults with chronic illnesses. We evaluated the accuracy of one of these devices, the TOSCA(®) 500, in adults admitted to an emergency department for acute respiratory failure.
We prospectively collected 29 pairs of simultaneous transcutaneous arterial CO(2) (PtcCO(2)) and arterial CO(2) (PaCO(2)) values in 21 consecutive adults with acute respiratory failure (acute heart failure, n = 6; COPD exacerbation, n = 8; acute pneumonia, n = 6; and pulmonary embolism, n = 1). Agreement between PaCO(2) and PtcCO(2) was evaluated using the Bland-Altman method.
Mean arterial oxygen saturation was 90%, arterial oxygen tension ranged from 32 to 215 mmHg, and PaCO(2) ranged from 23 to 84 mmHg. The mean difference between PaCO(2) and PtcCO(2) was 0.1 mmHg, and the Bland-Altman limits of agreement (bias ± 1.96 SD) ranged from -6 to 6.2 mmHg. None of the patients experienced adverse effects from heating of the device clipped to the earlobe.
PtcCO(2) showed good agreement with PaCO(2) in adults with acute respiratory failure.
经皮二氧化碳监测仪广泛应用于新生儿 ICU。直到最近，这些设备在成人中的表现仍不尽如人意。最近的技术改进产生了经皮二氧化碳监测仪，这些监测仪在患有慢性疾病的成人中表现良好。我们评估了其中一种设备 TOSCA（®）500 在因急性呼吸衰竭而入住急诊科的成人中的准确性。
我们前瞻性地收集了 21 名连续患有急性呼吸衰竭的成年人（急性心力衰竭 6 例；COPD 加重 8 例；急性肺炎 6 例；肺栓塞 1 例）的 29 对同时的经皮动脉二氧化碳（PtcCO（2））和动脉二氧化碳（PaCO（2））值。使用 Bland-Altman 方法评估 PaCO（2）与 PtcCO（2）之间的一致性。
平均动脉血氧饱和度为 90%，动脉血氧分压范围为 32 至 215mmHg，PaCO（2）范围为 23 至 84mmHg。PaCO（2）与 PtcCO（2）之间的平均差值为 0.1mmHg，Bland-Altman 一致性界限（偏倚±1.96 SD）范围为-6 至 6.2mmHg。没有患者因耳夹加热设备而出现不良反应。
经皮二氧化碳在急性呼吸衰竭的成人中与 PaCO（2）具有良好的一致性。
