Abstract
Monitoring of arterial Pco2 (Paco2) is of similar importance as monitoring of Pao2 , particularly in neonatal intensive care. We report about the first clinical application of a miniaturized heated electrode for transcutaneous continuous monitoring of Pco2 (tcPco2) (JWS et al, Acta anaesth scand Suppl 168:118,1978). Stability of the electrode, skin temperature necessary to obtain agreement of Paco2 and tcPco2 ,kinetical properties of the electrode and its performance on sick neonates were studied in 40 infants (830-3630 g). After calibration in 6% CO2 and N2 at 42° and 44° the electrode was attached to the skin at 44°, an inbuilt correction being made for thermal effects and skin CO2 production (Paco2=tcPco2 · e0.04(37-T)-4 torr). After 15 min at 44° tcPco2 was monitored at 42° for 1 hr, and again after 5 min of reheating to 44° to reestablish full vasodilatation. The mean drift in vitro was 0 over 3 hr, the drift in situ 0.4 ± 1.4 torr/hr (N=37). After 1 hr at 42° transient reheating to 44° did not significantly influence tcPco2, i.e.tcPco2 can be measured at lower skin temperatures than tcPo2 . We did not see burns. tcPco2 (Y; torr) agreed well with Paco2 (X; torr), irrespective of systolic blood pressure (30-85 mm Hg): Y=0.92X+1.50; N=116; r=0.88; syx=3.6. tcPco2 reacts promptly to crying, apnea or sustained alterations of alveolar ventilation but does not fluctuate during periodic breathing, although the in vitro 90% response time of 70 sec would allow a response similar to that of tcPo2 . Despite this damping -probably by the skin- the tcPco2 electrode may prove to be as useful for respiratory physiologists as we found it in neonatal intensive care.
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Versmold, H., Severinghaus, J., Müller, C. et al. Transcutaneous Monitoring of Pco2 In Newborn Infants: 26. Pediatr Res 14, 170 (1980). https://doi.org/10.1203/00006450-198002000-00053
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DOI: https://doi.org/10.1203/00006450-198002000-00053