Gal S, Riskin A, Chistyakov I, Shifman N, Srugo I, Kugelman A
Department of Pediatrics, Bnai Zion Medical Center, The B&R Rappaport Faculty of Medicine, Technion, 47 Golomb Street, Haifa, 31048, Israel,
Eur J Pediatr. 2015 Mar;174(3):319-24. doi: 10.1007/s00431-014-2407-2. Epub 2014 Aug 28.
Our objective was to assess within a feasibility study the correlation and agreement of transcutaneous carbon dioxide (PtcCO2) monitoring with venous carbon dioxide (PvCO2) in infants with bronchiolitis in the emergency room (ER) and pediatric department. Sixty infants (aged 3.6 ± 3.3 months) admitted to our ER with bronchiolitis were included. PtcCO2 measurements (SenTec Digital Monitoring System) collected prospectively were compared with simultaneous PvCO2 drawn for patient care. Analysis included 100 measurements. The correlation of PtcCO2 and PvCO2 (r = 0.71, p < 0.001) was good, and the agreement (mean difference ± standard deviation of the differences 1.9 ± 7.0 mmHg) was adequate; average PtcCO2 was slightly lower than PvCO2. Changes in PtcCO2 and PvCO2 for consecutive measurements within each patient correlated (r = 0.41, p < 0.01). The level of PtcCO2 correlated with disease severity clinical score (p < 0.001).
PtcCO2 monitoring was feasible in the ER and pediatric department and was found to have a good correlation and adequate agreement with PvCO2 in infants with bronchiolitis. Because the standard deviation of the differences was relatively high, though comparable to the literature, we suggest that PtcCO2 should not replace blood gas but rather serve as a complementary tool for trending and for real-time continuous assessment of the CO2 levels.
我们的目标是在一项可行性研究中评估急诊室(ER)和儿科病房中患细支气管炎的婴儿经皮二氧化碳(PtcCO2)监测与静脉血二氧化碳(PvCO2)之间的相关性和一致性。纳入了60名因细支气管炎入住我们急诊室的婴儿(年龄3.6±3.3个月)。将前瞻性收集的PtcCO2测量值(SenTec数字监测系统)与为患者护理同时采集的PvCO2进行比较。分析包括100次测量。PtcCO2与PvCO2的相关性良好(r = 0.71,p < 0.001),一致性(平均差值±差值的标准差为1.9±7.0 mmHg)尚可;平均PtcCO2略低于PvCO2。每位患者连续测量的PtcCO2和PvCO2变化具有相关性(r = 0.41,p < 0.01)。PtcCO2水平与疾病严重程度临床评分相关(p < 0.001)。
PtcCO2监测在急诊室和儿科病房是可行的,并且发现在患细支气管炎的婴儿中与PvCO2具有良好的相关性和足够的一致性。尽管与文献相当,但由于差值的标准差相对较高,我们建议PtcCO2不应替代血气分析,而应作为一种用于趋势分析和实时连续评估二氧化碳水平的补充工具。