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Exploring intermittent transcutaneous CO2 monitoring

Rauch, Daniel A. MD; Ewig, Jeffrey MD; Benoit, Pennie E. RN, CCRN; Clark, Eunice RN, BSN, CCRN; Bijur, Polly PhD

Clinical Investigations
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Objective: To explore the accuracy of a continuous transcutaneous CO2 (TcCO2) monitor, used in an intermittent rather than a continuous fashion, to obtain quick (<5 mins) CO2 readings.

Design: Prospective study.

Setting: An urban pediatric intensive care unit in a university teaching hospital.

Patients: A convenience sample of pediatric patients with indwelling arterial catheters.

Intervention: Transcutaneous monitoring was done simultaneous with arterial blood gas monitoring.

Measurements and Main Results: There were 49 simultaneous-readings on 19 patients, age 5 days to 16 years, with 13 different diagnoses. The TcCO2 was related to the PCO2 by a Pearson product coefficient of 0.79 (p < .0005), with a mean difference of 1.94 (TcCO2 > PCO2) and 95% confidence interval of −0.12 to 4.07. The scatterplot produces a regression line characterized by the following equation: PCO2 = (TcCO2 × 1.05) − 4.08.

Conclusions: Further study to evaluate intermittent TcCO2 as a practical clinical variable is warranted. This study should encourage refinement of the technology to be more accurate for this use.

From the Department of Pediatrics, Jacobi Medical Center, Bronx, NY (Dr. Rauch); the Albert Einstein College of Medicine, Bronx, NY (Dr. Bijur, Ms. Benoit, and Ms. Clark); and the Division of Pulmonary Medicine, All Children's Hospital, St. Petersburg, FL (Dr. Ewig).

Supported, in part, by an Albert Einstein College of Medicine Department of Pediatrics Interdivisional Research Program grant.

Address requests for reprints to: Daniel A. Rauch, MD, Department of Pediatrics, Room 803, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY 10461.

© 1999 Lippincott Williams & Wilkins, Inc.