Transcutaneous pCO2 monitoring in infants in the neonatal unit
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摘要Background: Continuous transcutaneous (Tc) pCO2 monitoring is a non-invasive method to continuously measure a patient’s blood pCO2 levels and has been shown to have good correlation with the gold standard, blood gas monitoring. There are few studies providing data upon which to determine the optimal use Tc pCO2 in preterm infants.

Objectives: To investigate the correlation, accuracy, and agreement of Tc pCO2 with blood gas monitoring and the factors affecting the accuracy of Tc pCO2 measurement.
Methods: Preterm infants admitted to the neonatal intensive care unit who required blood gas measurement to determine pCO2 values for clinical management were also connected to a Tc pCO2 monitoring device (SenTec Digital Monitoring System, SDM-PO2). Repeated measures correlation analysis and the mixed effects limits of agreement method were used to determine the correlation and agreement between the two methods, respectively. The validity of Tc monitor to detect abnormal pCO2 (<4 or > 7kPa) was also calculated.

Results: 14 infants were included (median gestational age: 27 weeks and median birthweight: 1004g) and a total of 771 paired measurements were compared. The correlation between these values was 0.70 (p<0.001). The mean bias was 0.66 with a 95% confidence limit of agreement (LoA) of -1.6 to 2.9 kPa (Fig.1). The sensitivity and specificity of SecTec monitor for abnormal pCO2 is 64% and 72%, respectively.

Conclusions: Strong correlation was found between the Tc pCO2 and corresponding blood gas measurements, and the mean bias between the methods was within the clinically acceptable range of ±1kPa. However, due to the wide range of LoA, and fair sensitivity and specificity to detect abnormal pCO2 levels, we concluded that auditing a revised Tc monitoring algorithm to determine whether blood sampling could safely be reduced was warranted.
著者P.H.Y. Chan, M.Y. Ip, H. S. Lam
會議名稱ANZNN Clinical Practice Improvement Conference

上次更新時間 2020-05-06 於 11:11