Author(s)
Samantha R. Scott, BA
Taylor Dugan, MSc
Sean Setzen, BA
Chad Pezzano, MA RRT-NPS
Paul Feustel, MEng PhD
Lara Reichert, MD MPH
Affiliation(s)
Albany Medical College; Dept of Otolaryngology, Albany Medical Center; Dept of Pediatrics, Albany Medical Center; Dept of Neuroscience & Experimental Therapeutics, Albany Medical Center; Department of Cardiorespiratory Services, Albany Medical Center;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand the accuracy of transcutaneous CO2 monitoring as it relates to venous, arterial, and capillary CO2 values between and within racial groups.
Objectives: Transcutaneous CO2 monitors (TCOMs) are used to noninvasively monitor blood CO2 levels in acute care settings, however, their accuracy has been shown to vary. We sought to study the correlation between TCOMs and arterial, capillary, and venous CO2 blood gas measurements in neonatal patients. We also sought to examine any variability across different racial groups.
Study Design: Using a retrospective chart review, we analyzed CO2 data in our neonatal ICU over 1 year. We collected arterial, venous, and capillary CO2 measurements that occurred within one hour of TCOM measurement.
Methods: A Bland-Altman analysis examined the degree of bias present between TCOMs and arterial, venous, and capillary CO2.
Results: 25 patients were studied over a 1 year period. Arterial measurements maintained the highest degree of difference from TCOM values (degree of bias 9.3 torr). Venous monitoring and TCOMs yielded the lowest degree of bias (-.46 torr), though this sample size was the lowest of our blood gas types. Capillary POC testing values yielded an intermediate bias (4.12 torr). Greater agreement existed when blood gas CO2 values increased over time for a given patient. No difference in the amount of bias was appreciated between racial groups.
Conclusions: Transcutaneous CO2 monitoring in NICU patients is within the accepted manufacturer range of error when compared to blood gas analysis and can be considered an accurate, noninvasive method of monitoring. Capillary point of care analysis is an efficient means of confirming TCOMs and had better agreement than the more invasive arterial gases.