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Title: Transcutaneous measurement of carbon dioxide tension during extended monitoring: evaluation of accuracy and stability, and an algorithm for correcting calibration drift.
Austin Authors: Berlowitz, David J ;Spong, Jo;O'Donoghue, Fergal J ;Pierce, Robert J;Brown, Douglas J;Campbell, Donald A;Catcheside, Peter G;Gordon, Ian R;Rochford, Peter D 
Affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 21-Jan-2011
Publication information: Respiratory Care 2011; 56(4): 442-8
Abstract: When polysomnography is indicated in a patient with a presumed sleep disorder, continuous monitoring of arterial carbon dioxide tension (P(aCO(2))) is desirable, especially if nocturnal hypoventilation is suspected. Transcutaneous CO(2) monitors (P(tcCO(2))) provide a noninvasive correlate of P(aCO(2)), but their accuracy and stability over extended monitoring have been considered inadequate for the diagnosis of hypoventilation. We examined the stability and accuracy of P(tcCO(2)) measurements and the performance of a previously described linear interpolation technique designed to correct for calibration drift.We compared the P(tcCO(2)) values from 2 TINA TCM-3 monitors to P(aCO(2)) values from arterial blood samples obtained at the beginning, every 15 min of the first hour, and then hourly over 8 hours of monitoring in 6 hemodynamically stable, male, intensive care patients (mean age 46 ± 17 y).Time had a significant (P = .002) linear effect on the P(tcCO(2))-P(aCO(2)) difference, suggesting calibration drift over the monitoring period. We found no differences between monitor type or interaction between time and monitor type. For the 2 monitors the uncorrected bias was 3.6 mm Hg and the limits of agreement were -5.1 to 12.3 mm Hg. Our linear interpolation algorithm improved the bias and limits of agreement to 0.4 and -5.5 to 6.4 mm Hg, respectively.Following stabilization and correction for both offset and drift, P(tcCO(2)) tracks P(aCO(2)) with minimal residual bias over 8 hours of monitoring. Should future research confirm these findings, then interpolated P(tcCO(2)) may have an increased role in detecting sleep hypoventilation and assessing the efficacy of treatment.
Gov't Doc #: 21255486
DOI: 10.4187/respcare.00454
Journal: Respiratory care
Type: Journal Article
Subjects: Adult
Blood Gas Monitoring, Transcutaneous
Carbon Dioxide.analysis
Middle Aged
Reproducibility of Results
Sleep Apnea Syndromes.physiopathology
Time Factors
Appears in Collections:Journal articles

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