Department of Emergency Medicine and Surgery, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris, 47-83 boulevard de l'hôpital, 75013 Paris, France.
Am J Emerg Med. 2012 Nov;30(9):1872-6. doi: 10.1016/j.ajem.2012.03.033. Epub 2012 Jul 12.
Transcutaneous carbon dioxide pressure (PtcCO(2)) has been suggested as a noninvasive surrogate of arterial carbon dioxide pressure (PaCO(2)). Our study evaluates the reliability of this method in spontaneously breathing patients in an emergency department.
A prospective, observational study was performed in nonintubated dyspneic patients who required measurement of arterial blood gases. Simultaneously and blindly to the physicians in charge, PtcCO(2) was measured using a TOSCA 500 monitor (Radiometer, Villeurbanne, France). Agreement between PaCO(2) and PtcCO(2) was assessed using the Bland-Altman method.
Forty-eight patients (mean age, 65 years) were included, and 50 measurements were done. Eleven (23%) had acute heart failure; 10 (21%), pneumonia; 7 (15%), acute asthma; and 7 (15%), exacerbation of chronic obstructive pulmonary disease. Median PaCO(2) was 42 mm Hg (range, 17-109). Mean difference between PaCO(2) and PtcCO(2) was 1 mm Hg with 95% limits of agreement of -3.4 to +5.6 mm Hg. All measurement differences were within 5 mm Hg, and 32 (64%) were within 2 mm Hg.
Transcutaneous carbon dioxide pressure accurately predicts PaCO(2) in spontaneously breathing patients.
经皮二氧化碳分压（PtcCO2）已被提议作为动脉二氧化碳分压（PaCO2）的无创替代指标。我们的研究评估了这种方法在急诊科自主呼吸患者中的可靠性。
对需要测量动脉血气的非插管呼吸困难患者进行了前瞻性、观察性研究。同时，在主管医生不知情的情况下，使用 TOSCA 500 监测仪（法国里埃博纳的 Radiometer）测量 PtcCO2。使用 Bland-Altman 方法评估 PaCO2 和 PtcCO2 之间的一致性。
共纳入 48 例患者（平均年龄 65 岁），共进行了 50 次测量。11 例（23%）为急性心力衰竭；10 例（21%）为肺炎；7 例（15%）为急性哮喘；7 例（15%）为慢性阻塞性肺疾病恶化。中位 PaCO2 为 42mmHg（范围 17-109mmHg）。PaCO2 和 PtcCO2 之间的平均差值为 1mmHg，95%一致性界限为-3.4 至+5.6mmHg。所有测量差异均在 5mmHg 以内，32 例（64%）在 2mmHg 以内。
经皮二氧化碳分压在自主呼吸患者中能准确预测 PaCO2。
