Division of Neonatology, Department of Paediatrics, Catholic University of Sacred Heart, Largo Gemelli 8, I-00168 Rome, Italy.
Sensors (Basel). 2012;12(8):10980-9. doi: 10.3390/s120810980. Epub 2012 Aug 8.
Arterial oxygen saturation (SaO(2)) and partial arterial pressure of carbon dioxide (PaCO(2)) are important respiratory parameters in critically ill neonates. A sensor combining a pulse oximeter with the Stow-Severinghaus electrode, required for the measurement of peripheral oxygen saturation (SpO(2)) and transcutaneous partial pressure of carbon dioxide (PtcCO(2)), respectively, has been recently used in neonatal clinical practice (TOSCA(500Ò)Radiometer). We evaluated TOSCA usability and reliability in the delivery room (DR), throughout three different periods, on term, late-preterm, and preterm neonates. During the first period (period A), 30 healthy term neonates were simultaneously monitored with both TOSCA and a MASIMO pulse oximeter. During the second period (period B), 10 healthy late-preterm neonates were monitored with both TOSCA and a transcutaneous device measuring PtcCO(2) (TINA(Ò) TCM3, Radiometer). During the third period (period C), 15 preterm neonates were monitored with TOSCA and MASIMO after birth, during stabilization, and during transport to the neonatal intensive care unit (NICU). Blood gas analyses were performed to compare transcutaneous and blood gas values. TOSCA resulted easily and safely usable in the DR, allowing reliable noninvasive SaO(2) estimation. Since PtcCO(2) measurements with TOSCA required at least 10 min to be stable and reliable, this parameter was not useful during the early resuscitation immediately after birth. Moreover, PtcCO(2) levels were less precise if compared to the conventional transcutaneous monitoring. However, PtcCO(2) measurement by TOSCA was useful as trend-monitoring after stabilization and during transport to NICU.
动脉血氧饱和度 (SaO(2)) 和动脉二氧化碳分压 (PaCO(2)) 是危重新生儿的重要呼吸参数。一种将脉搏血氧仪与 Stow-Severinghaus 电极相结合的传感器，分别用于测量外周血氧饱和度 (SpO(2)) 和经皮二氧化碳分压 (PtcCO(2))，最近已在新生儿临床实践中使用（TOSCA(500Ò)Radiometer）。我们评估了 TOSCA 在产房 (DR) 的可用性和可靠性，在三个不同时期对足月、晚期早产儿和早产儿进行了评估。在第一期（A 期），30 名健康的足月新生儿同时接受 TOSCA 和 MASIMO 脉搏血氧仪监测。在第二期（B 期），10 名健康的晚期早产儿同时接受 TOSCA 和测量 PtcCO(2) 的经皮设备（TINA(Ò) TCM3，Radiometer）监测。在第三期（C 期），15 名早产儿在出生后、稳定期和转运至新生儿重症监护病房 (NICU) 期间接受 TOSCA 和 MASIMO 监测。进行血气分析以比较经皮血气值。TOSCA 在 DR 中易于使用且安全，可可靠地进行无创性 SaO(2) 估计。由于 TOSCA 测量 PtcCO(2) 需要至少 10 分钟才能稳定和可靠，因此该参数在出生后立即进行的早期复苏期间没有用处。此外，与传统的经皮监测相比，PtcCO(2) 水平的精度较低。然而，TOSCA 测量的 PtcCO(2)在稳定后和转运至 NICU 期间作为趋势监测是有用的。
