Combined oximetry-cutaneous capnography in patients assessed for long-term oxygen therapy.

STUDY AIM To evaluate the feasibility of combined oximetry (pulse oximetric saturation [Spo(2)]) and cutaneous capnography (transcutaneous carbon dioxide tension [Ptcco(2)]) for oxygen titration in patients requiring long-term oxygen therapy. METHODS Twenty patients with obstructive or restrictive lung disease underwent oxygen titration using a combined cutaneous oximetry-capnography sensor. The goal of titration was to achieve an oxygen saturation of > 90% without a significant rise in carbon dioxide. Spo(2) and Ptcco(2) measurements at the end of titration were compared with blood gas levels using Bland-Altman analysis and linear regression analysis. RESULTS The mean (+/- SE of the estimate) Pao(2) while breathing room air was 53.2 +/- 8.1 mm Hg and increased to 75.9 +/- 13.3 mm Hg with oxygen supplementation (p < 0.0001). The mean Paco(2) was 45.9 +/- 8.7 mm Hg at baseline and 47.8 +/- 9.0 mm Hg after oxygen titration (p = 0.003). Bland-Altman analysis for comparison of Ptcco(2) and Paco(2) showed a bias of 0.86 mm Hg with a precision of 3.48 mm Hg. Bland-Altman analysis for the comparison of Spo(2) and arterial oxygen saturation showed a bias of 0.14% with a precision of 1.13%. CONCLUSION Combined oximetry and cutaneous capnography is feasible during oxygen titration in patients needing long-term oxygen therapy. This noninvasive approach has the potential to reduce the number of arterial blood gas samplings performed.

[1]  Cotes Je,et al.  LONG TERM DOMICILIARY OXYGEN THERAPY IN CHRONIC HYPOXIC COR PULMONALE COMPLICATING CHRONIC BRONCHITIS AND EMPHYSEMA Report of the Medical Research Council Working Party , 1981, The Lancet.

[2]  M. Tamm,et al.  Cutaneous carbon dioxide monitoring in adults , 2004, Current opinion in anaesthesiology.

[3]  E. W. Russi,et al.  Revidierte Richtlinien 2006 für die langfristige Sauerstoffheimtherapie , 2007 .

[4]  A. Crockett,et al.  Adult domiciliary oxygen therapy. Position statement of the Thoracic Society of Australia and New Zealand , 1998, The Medical journal of Australia.

[5]  P. Lange,et al.  Does long-term oxygen therapy reduce hospitalisation in hypoxaemic chronic obstructive pulmonary disease? , 2002, European Respiratory Journal.

[6]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[7]  C. Beglinger,et al.  Combined Pulse Oximetry/Cutaneous Carbon Dioxide Tension Monitoring during Colonoscopies: Pilot Study with a Smart Ear Clip , 2005, Digestion.

[8]  W. MacNee,et al.  Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper , 2004, European Respiratory Journal.

[9]  L. Brochard,et al.  Transcutaneous arterial carbon dioxide pressure monitoring in critically ill adult patients , 2006, Intensive Care Medicine.

[10]  G. Gibson,et al.  Evaluation of a transcutaneous carbon dioxide monitor ("TOSCA") in adult patients in routine respiratory practice. , 2007, Respiratory medicine.

[11]  S. Hurd,et al.  Global Strategy for the Diagnosis, Management and Prevention of COPD: 2003 update , 2003, European Respiratory Journal.

[12]  M. Weiss,et al.  Evaluation of a new combined SpO2/PtcCO2 sensor in anaesthetized paediatric patients , 2003, Paediatric anaesthesia.

[13]  T. De,et al.  Parenteral nutrition before gastrointestinal surgery. , 1982 .

[14]  D. Spahn,et al.  Combining transcutaneous blood gas measurement and pulse oximetry. , 2002, Anesthesia and analgesia.

[15]  Roman Rohling,et al.  Performance of a Digital PCO2/SpO2 Ear Sensor , 2003, Journal of Clinical Monitoring and Computing.

[16]  J. Severinghaus.  A combined transcutaneous PO2-PCO2 electrode with electrochemical HCO3- stabilization. , 1981, Journal of applied physiology: respiratory, environmental and exercise physiology.