Concordance between transcutaneous and arterial measurements of carbon dioxide in an ED.

Samuel Delerme, Viviane Montout, Hélène Goulet, Amandine Arhan, Frederic Le Saché, Catherine Devilliers, Bruno Riou, Patrick Ray

Department of Emergency Medicine and Surgery, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris, 47-83 boulevard de l'hôpital, 75013 Paris, France. samuel.delerme@psl.aphp.fr

The American journal of emergency medicine 2012 Nov

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Transcutaneous carbon dioxide pressure (PtcCO(2)) has been suggested as a noninvasive surrogate of arterial carbon dioxide pressure (PaCO(2)). Our study evaluates the reliability of this method in spontaneously breathing patients in an emergency department. A prospective, observational study was performed in nonintubated dyspneic patients who required measurement of arterial blood gases. Simultaneously and blindly to the physicians in charge, PtcCO(2) was measured using a TOSCA 500 monitor (Radiometer, Villeurbanne, France). Agreement between PaCO(2) and PtcCO(2) was assessed using the Bland-Altman method. Forty-eight patients (mean age, 65 years) were included, and 50 measurements were done. Eleven (23%) had acute heart failure; 10 (21%), pneumonia; 7 (15%), acute asthma; and 7 (15%), exacerbation of chronic obstructive pulmonary disease. Median PaCO(2) was 42 mm Hg (range, 17-109). Mean difference between PaCO(2) and PtcCO(2) was 1 mm Hg with 95% limits of agreement of -3.4 to +5.6 mm Hg. All measurement differences were within 5 mm Hg, and 32 (64%) were within 2 mm Hg. Transcutaneous carbon dioxide pressure accurately predicts PaCO(2) in spontaneously breathing patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Citation

Samuel Delerme, Viviane Montout, Hélène Goulet, Amandine Arhan, Frederic Le Saché, Catherine Devilliers, Bruno Riou, Patrick Ray. Concordance between transcutaneous and arterial measurements of carbon dioxide in an ED. The American journal of emergency medicine. 2012 Nov;30(9):1872-6