Key result
Transcutaneous CO2 monitoring demonstrated a significantly smaller bias compared to arterial CO2 (2.35 mmHg) than end-tidal CO2 monitoring (6.93 mmHg) during one-lung ventilation (P < 0.05).
Why the study?
Does transcutaneous CO2 monitoring improve the accuracy of estimating arterial CO2 compared to end-tidal CO2 monitoring in patients undergoing one-lung ventilation?
Observational (n=18)
No
Does transcutaneous CO2 monitoring improve the accuracy of estimating arterial CO2 compared to end-tidal CO2 monitoring in patients undergoing one-lung ventilation?
Absolute Event Rate: 2.35% vs 6.93%
p-value: p=<0.05
Transcutaneous CO2 monitoring is more accurate than end-tidal CO2 monitoring for estimating arterial CO2 levels during one-lung ventilation in thoracic surgery.
May support transcutaneous over end-tidal CO2 monitoring for arterial estimation during one-lung ventilation; hypothesis-generating pending prospective validation.
Background:In thoracic anesthesia with one lung ventilation (OLV), end-tidal CO2 (PeTCO2) monitoring may not be accurate to estimate PaCO2 mainly due to ventilation/perfusion mismatching.This study aimed to asses the clinical usefulness and accuracy of a transcutaneous CO2 (PtCCO2) monitoring in thoracic anesthesia, compared with PeTCO2.Methods: 18 patients of ASA physical status 1 or 2, required a long period of OLV were researched.The lungs were mechanically ventilated in the lateral decubitus position.We measured PaCO2, PeTCO2, PtCCO2 during two lung ventilation (TLV) and 15 min, 30 min, 60 min after OLV.For comparing the differences of PtCCO2/PaCO2 and PtCCO2/PaCO2, we figured out bias (mean difference between values) and precision (standard deviation of bias) by using Bland-Altman plot.We compared the differences of each value, PeTCO2/PaCO2, PtCCO2/PaCO2, using the student`s t-test.Results: The bias ± precision of PeTCO2/PaCO2 and PtCCO2/PaCO2 was each 7.82 mmHg ± 3.98 mmHg, 1.95 mmHg ± 2.66 mmHg during TLV and that of mean value of PeTCO2/PaCO2 and PtCCO2/PaCO2 was each 6.93 mmHg ± 2.6 mmHg, 2.35 mmHg ± 1.66 mmHg during OLV.PtCCO2/PaCO2 differences were significantly less than PeTCO2/PaCO2 differences (P ＜ 0.05).Conclusions: During one lung ventilation, PtCCO2 monitoring is more useful and accurate than PeTCO2 monitoring for assessing PaCO2 levels.(Korean J Anesthesiol 2008; 54: 129∼33)
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Choi et al. (2008) conducted an observational in Thoracic surgery requiring one-lung ventilation (n=18). Transcutaneous CO2 (PtCCO2) monitoring vs. End-tidal CO2 (PeTCO2) monitoring was evaluated on Bias (mean difference) compared to arterial CO2 (PaCO2) during one-lung ventilation (p=<0.05). Transcutaneous CO2 monitoring demonstrated a significantly smaller bias compared to arterial CO2 (2.35 mmHg) than end-tidal CO2 monitoring (6.93 mmHg) during one-lung ventilation (P < 0.05).
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