Holowaychuk Marie K, Fujita Hiroshi, Bersenas Alexa M E
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
J Vet Emerg Crit Care (San Antonio). 2014 Sep-Oct;24(5):545-53. doi: 10.1111/vec.12216. Epub 2014 Sep 3.
To describe the use of a transcutaneous blood gas monitoring system in critically ill dogs, determine if transcutaneous and arterial blood gas values have good agreement, and verify if clinical or laboratory variables are correlated with differences between transcutaneous and arterial blood gas measurements.
Prospective observational study.
University teaching hospital ICU.
Twenty-three client-owned dogs.
In critically ill dogs undergoing arterial blood gas monitoring, a transcutaneous blood gas monitor was used to measure transcutaneous partial pressure of carbon dioxide (PtcCO2 ) and transcutaneous partial pressure of oxygen (PtcO2 ) values 30 minutes after sensor placement, which were compared to PaCO2 and PaO2 values measured simultaneously. Clinical and laboratory variables were concurrently recorded to determine if they were correlated with the difference between transcutaneous and arterial blood gas measurements.
Bland-Altman analysis revealed a mean bias of 4.6 ± 26.3 mm Hg (limits of agreement [LOA]: -46.9/+56.1 mm Hg) between PtcO2 and PaO2 and a mean bias of 9.3 ± 8.5 mm Hg (LOA: -7.5/+26.0 mm Hg) between PtcCO2 and PaCO2 . The difference between PtcCO2 -PaCO2 was strongly negatively correlated with HCO3 (-) (r(2) = 0.52, P < 0.001) and PaCO2 (r(2) = 0.58, P < 0.001) and weakly positively correlated with diastolic blood pressure (r(2) = 0.21, P = 0.044), whereas the difference between PtcCO2 -PaCO2 was moderately negatively correlated with diastolic blood pressure (r(2) = 0.33, P = 0.008).
Agreement between transcutaneous and arterial PO2 and PCO2 measurements in these critically ill dogs was inferior to that reported in similar adult and pediatric human studies. The transcutaneous monitor consistently over-estimated PaO2 and PaCO2 and should not be used to replace arterial blood gas measurements in critically ill dogs requiring blood gas interpretation.
描述经皮血气监测系统在危重病犬中的应用，确定经皮和动脉血气值是否具有良好的一致性，并验证临床或实验室变量是否与经皮和动脉血气测量值之间的差异相关。
前瞻性观察性研究。
大学教学医院重症监护病房。
23只客户拥有的犬。
在接受动脉血气监测的危重病犬中，使用经皮血气监测仪在传感器放置30分钟后测量经皮二氧化碳分压（PtcCO2）和经皮氧分压（PtcO2）值，并与同时测量的PaCO2和PaO2值进行比较。同时记录临床和实验室变量，以确定它们是否与经皮和动脉血气测量值之间的差异相关。
Bland-Altman分析显示，PtcO2和PaO2之间的平均偏差为4.6±26.3 mmHg（一致性界限[LOA]：-46.9/+56.1 mmHg），PtcCO2和PaCO2之间的平均偏差为9.3±8.5 mmHg（LOA：-7.5/+26.0 mmHg）。PtcCO2 - PaCO2之间的差异与HCO3（-）（r(2)=0.52，P<0.001）和PaCO2（r(2)=0.58，P<0.001）呈强负相关，与舒张压呈弱正相关（r(2)=0.21，P=0.044），而PtcO2 - PaO2之间的差异与舒张压呈中度负相关（r(2)=0.33，P=0.008）。
这些危重病犬经皮和动脉PO2及PCO2测量值之间的一致性低于类似的成人和儿科人体研究报告。经皮监测仪持续高估PaO2和PaCO2，在需要进行血气解读的危重病犬中，不应使用经皮监测仪替代动脉血气测量。
