Department of Respiratory Diseases, Hospital of Sestri Levante, Chiavarese, Italy.
Ann Thorac Med. 2011 Oct;6(4):217-20. doi: 10.4103/1817-1737.84776.
Non-invasive measurement of oxygenation is a routine procedure in clinical practice, but transcutaneous monitoring of PCO(2)(PtCO(2)) is used much less than expected.
The aim of our study was to analyze the value of a commercially available combined SpO(2)/PtCO(2) monitor (TOSCA-Linde Medical System, Basel, Switzerland) in adult non-invasive ventilated patients with acute respiratory failure. Eighty critically ill adult patients, requiring arterial blood sample gas analyses, underwent SpO(2) and PtCO(2) measurements (10 min after the probe was attached to an earlobe) simultaneously with arterial blood sampling. The level of agreement between PaCO(2) - PtCO(2) and SaO(2) - SpO(2)was assessed by Bland-Altman analyses.
Both, SaO(2) from blood gas analysis and SpO(2) from the transcutaneous monitor, and PaCO(2) and PtCO(2) were equally useful. No measurements were outside of the acceptable clinical range of agreement of ± 7.5 mmHg.
The accuracy of estimation of the TOSCA transcutaneous electrode (compared with the "gold standard" blood sample gas analysis) was generally good. Moreover, TOSCA presents the advantage of the possibility of continuous non-invasive measurement. The level of agreement of the two methods of measurement allows us to state that the TOSCA sensor is useful in routine monitoring of adults admitted to an intermediate respiratory unit and undergoing non-invasive ventilation.
在临床实践中，无创性氧合监测是常规程序，但经皮二氧化碳监测（PtCO2）的使用却远低于预期。
我们的研究目的是分析一种市售的组合式 SpO2/PtCO2 监测仪（TOSCA-Linde Medical System，巴塞尔，瑞士）在急性呼吸衰竭的成人无创通气患者中的应用价值。80 名需要动脉血气分析的危重病成年患者，在探头贴于耳廓后 10 分钟，同时进行 SpO2 和 PtCO2 测量和动脉采血。通过 Bland-Altman 分析评估 PaCO2-PtCO2 和 SaO2-SpO2 之间的一致性。
血气分析的 SaO2 和经皮监测的 SpO2，以及 PaCO2 和 PtCO2 均同样有用。没有测量值超出可接受的临床一致性范围（±7.5mmHg）。
TOSCA 经皮电极的估计准确性（与“金标准”血气分析相比）总体上良好。此外，TOSCA 具有连续无创测量的可能性的优势。两种测量方法的一致性水平使我们能够指出 TOSCA 传感器在接受无创通气的成人入住中级呼吸病房的常规监测中是有用的。
