Department of Anesthesiology, Center for Cancer and Organ Dysfunction, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Anesthesiology, Odense University Hospital and Faculty of Health Science, University of Southern Denmark, Odense, Denmark.
J Clin Monit Comput. 2023 Oct;37(5):1255-1264. doi: 10.1007/s10877-023-00982-x. Epub 2023 Feb 18.
Postoperative monitoring of circulation and respiration is pivotal to guide intervention strategies and ensure patient outcomes. Transcutaneous blood gas monitoring (TCM) may allow for noninvasive assessment of changes in cardiopulmonary function after surgery, including a more direct assessment of local micro-perfusion and metabolism. To form the basis for studies assessing the clinical impact of TCM complication detection and goal-directed-therapy, we examined the association between clinical interventions in the postoperative period and changes in transcutaneous blood gasses.
Two-hundred adult patients who have had major surgery were enrolled prospectively and monitored with transcutaneous blood gas measurements (oxygen (TcPO) and carbon dioxide (TcPCO)) for 2 h in the post anaesthesia care unit, with recording of all clinical interventions. The primary outcome was changes in TcPO, secondarily TcPCO, from 5 min before a clinical intervention versus 5 min after, analysed with paired t-test.
Data from 190 patients with 686 interventions were analysed. During clinical interventions, a mean change in TcPO of 0.99 mmHg (95% CI-1.79-0.2, p = 0.015) and TcPCO of-0.67 mmHg (95% CI 0.36-0.98, p < 0.001) was detected.
Clinical interventions resulted in significant changes in transcutaneous oxygen and carbon dioxide. These findings suggest future studies to assess the clinical value of changes in transcutaneous PO2 and PCO2 in a postoperative setting.
Clinical trial number: NCT04735380.
术后循环和呼吸监测对于指导干预策略和确保患者预后至关重要。经皮血气监测（TCM）可用于非侵入性评估手术后心肺功能的变化，包括对局部微循环和代谢的更直接评估。为了为评估 TCM 并发症检测和目标导向治疗的临床影响的研究奠定基础，我们研究了术后期间临床干预与经皮血气变化之间的关系。
前瞻性纳入 200 名接受过重大手术的成年患者，并在麻醉后护理单元中使用经皮血气测量（氧（TcPO）和二氧化碳（TcPCO））监测 2 小时，记录所有临床干预措施。主要结局是与临床干预前 5 分钟相比，临床干预后 5 分钟 TcPO 的变化，采用配对 t 检验进行分析。
对 190 名患者的 686 项干预措施进行了数据分析。在临床干预期间，检测到 TcPO 平均变化 0.99mmHg（95%CI-1.79-0.2，p=0.015）和 TcPCO 平均变化-0.67mmHg（95%CI 0.36-0.98，p<0.001）。
临床干预导致经皮氧和二氧化碳显著变化。这些发现表明，未来的研究需要评估术后经皮 PO2 和 PCO2 变化的临床价值。
NCT04735380。
