Arterial and transcutaneous variability and agreement between multiple successive measurements of carbon dioxide in patients with chronic obstructive lung disease

• DOI: 10.1016/j.resp.2020.103486
• Publication Date: 2020-06-29T15:43:59Z
• Authors: Lars Pilegaard Th...; Thea Heide Faaborg; Stephen Edward Rees; Ulla Møller Weinr...
• Keywords: Male; Chronic obstructive pulmonary disease; Oxygen Inhalation Therapy; Reproducibility of Results; Carbon Dioxide; Middle Aged; Arterial blood gas measurement; Transcutaneous blood gas measurement; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; 0302 clinical medicine; Carbon dioxide; Long-term oxygen therapy; Physiologic monitoring; Humans; Female; Blood Gas Analysis; Respiratory Insufficiency; Blood Gas Monitoring, Transcutaneous; Aged

This study evaluates agreement between carbon dioxide measured arterial (PaCO2) and transcutaneous (PtcCO2) over time, by repeated successive measures, taking into consideration the inherent variability of arterial measurements.11 patients receiving LTOT, with severe to very severe COPD in a stable phase were studied. Repeated arterial blood samples were drawn and PtcCO2 measured simultaneously at the ear lobe. Bland-Altman analysis was used to evaluate 95 % limits of agreement (LoA). 194 paired samples were analysed. Following correction for bias, the difference between PaCO2 and PtCO2 during dynamic conditions was 0.02 kPa and LoA 0.94 to -0.90 kPa while 29 % of PtCO2 measurements were outside the range of variability for arterial measurements.PtcCO2 corrected for intra-patient bias provide reasonable description of PaCO2 values within but not outside steady state conditions. Our results suggest that PtcCO2 is a valuable method for monitoring in chronic rather than acute conditions when bias can be removed.