Aly Safwat, El-Dib Mohamed, Mohamed Mohamed, Aly Hany
Department of Pediatrics, Children's National Medical Center, The George Washington University, Washington, District of Columbia.
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Am J Perinatol. 2017 Apr;34(5):480-485. doi: 10.1055/s-0036-1593352. Epub 2016 Sep 27.
Obtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO monitoring using reduced-temperature probes (41°C). The objective of this study was to assess reliability and safety of tcPCO monitoring at reduced-temperature probe in VLBW infants. A prospective study was conducted on VLBW infants. tcPCO was monitored for 12 hours. Default skin probe temperature was adjusted at 41°C. Blood gases were done as clinically indicated. Arterial partial pressure of CO (PaCO) as well as capillary CO were compared with simultaneous tcPCO. A total of 124 data points were identified from 50 patients (gestational age [GA] = 28.1 ± 2.4 weeks and birth weight [BW] = 1,035 ± 291 g). Patients were supported with continuous positive airway pressure (40%), noninvasive positive pressure ventilation (16%), mechanical ventilation (18%), and high-frequency oscillation ventilation (24%). PaCO was measured using either capillary (58%) or arterial (42%) samples. Mean CO did not differ between tcPCO (51.3 ± 16) and PaCO (49.1 ± 13.7) mm Hg. tcPCO showed positive correlation with partial pressure of CO ( = 0.6, < 0.001). This correlation continued to be significant after controlling for GA, postmenstrual age, type of sample, and pH. No skin complications were reported. tcPCO monitoring using a temperature of 41°C is feasible and reliable in VLBW infants.
在极低出生体重（VLBW）婴儿中获取血气是一种侵入性操作。使用经皮二氧化碳（tcPCO）的研究报告了高温探头存在多种皮肤并发症。关于使用低温探头（41°C）进行tcPCO监测的数据不足。 本研究的目的是评估在VLBW婴儿中使用低温探头进行tcPCO监测的可靠性和安全性。 对VLBW婴儿进行了一项前瞻性研究。对tcPCO进行了12小时的监测。将默认皮肤探头温度调整为41°C。根据临床指征进行血气分析。将动脉血二氧化碳分压（PaCO）以及毛细血管血二氧化碳与同时进行的tcPCO进行比较。 从50例患者（胎龄[GA]=28.1±2.4周，出生体重[BW]=1035±291g）中总共确定了124个数据点。患者接受持续气道正压通气（40%）、无创正压通气（16%）、机械通气（18%）和高频振荡通气（24%）支持。使用毛细血管血样本（58%）或动脉血样本（42%）测量PaCO。tcPCO（51.3±16）和PaCO（49.1±13.7）mmHg之间的平均二氧化碳分压无差异。tcPCO与二氧化碳分压呈正相关（r=0.6，P<0.001）。在控制了胎龄、月经后年龄、样本类型和pH值后，这种相关性仍然显著。未报告皮肤并发症。 在VLBW婴儿中，使用41°C温度进行tcPCO监测是可行且可靠的。
