Erratum: Concordance and limits between transcutaneous and arterial carbon dioxide pressure in emergency department patients with acute respiratory failure: a single-center, prospective, and observational study

Bobbia, Xavier; Claret, Pierre‐Géraud; Palmier, Ludovic; Robert, Michaël; Granpierre, Romain Genre; Roger, Claire; Yan, Justin; Ray, Patrick; Sebbane, Mustapha; Muller, Laurent; Coussaye, Jean-Emmanuel de La

doi:10.1186/s13049-015-0154-7

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…The correlation between PaCO 2 and TCO 2 has been established in ED settings, specifically in patients with acute respiratory failure. 17 , 18 , 19 , 20 , 21 , 22 Lermuzeaux et al. showed that TCO 2 had a stronger correlation with PaCO 2 than ETCO 2 in these patients, which could be because of the increase in alveolar dead space that artificially lowers ETCO 2 compared with PaCO 2 .…”

Section: Discussionmentioning

confidence: 90%

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The utility of transcutaneous carbon dioxide measurements in the emergency department: A prospective cohort study

et al. 2021

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Background Rapid identification of patients with occult injury and illness in the emergency department can be difficult. Transcutaneous carbon dioxide (TCO 2 ) and oxygen (TO 2 ) measurements may be non‐invasive surrogate markers for the identification of such patients. Objectives To determine if TCO 2 or TO 2 are useful adjuncts for identifying severe illness and the correlation between TCO 2 , lactate, and end tidal carbon dioxide (ETCO 2 ). Methods Prospective TCO 2 and TO 2 measurements at a tertiary level 1 trauma center were obtained using a transcutaneous sensor on 300 adult patients. Severe illness was defined as death, intensive care unit (ICU) admission, bilevel positive airway pressure, vasopressor use, or length of stay >2 days. TCO 2 and TO 2 were compared to illness severity using t tests and correlation coefficients. Results Mean TO 2 did not differ between severe illness (58.9, 95% CI 54.9–62.9) and non‐severe illness (58.0, 95% CI 54.7–61.1). Mean TCO 2 was similar between severe (34.6, 95% CI 33–36.2) vs non‐severe illness (35.9, 95% CI 34.7–37.1). TCO 2 was 28.7 (95% CI 24.0–33.4) for ICU vs. 35.9 (95% CI 34.9–36.9) for non‐ICU patients. The mean TCO 2 in those with lactate > 2.0 was 29.8 (95% CI 25.8–33.8) compared with 35.7 (95% CI 34.9–36.9) for lactate < 2.0. TCO 2 was not correlated with ETCO 2 (r = 0.32, 95% CI 0.22–0.42). Conclusion TCO 2 could be a useful adjunct for identifying significant injury and illness and patient outcomes in an emergency department (ED) population. TO 2 did not predict severe illness. TCO 2 and ETCO 2 are only moderately correlated, indicating that they are not equivalent and may be useful under different circumstances.

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Section: Discussionmentioning

confidence: 90%

“…The correlation between PaCO 2 and TCO 2 has been established in ED settings, specifically in patients with acute respiratory failure 17–22 . Lermuzeaux et al.…”

Section: Discussionmentioning

confidence: 99%

The utility of transcutaneous carbon dioxide measurements in the emergency department: A prospective cohort study

et al. 2021

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“…Nonetheless, Conway et al recently pooled the available literature on the accuracy and precision of TCM to offer the most complete picture about this issue in a review with extensive meta-analysis (whole pooled population: 7,021 paired measurements, 2,817 patients in 73 studies; ICU patients: 16 studies (22% of 73 reviewed studies) with n=2,128 measurements; acute respiratory failure, 14 studies, n=993 paired measurements). In the whole population, they concluded that there are substantial differences between tcPCO 2 and artPCO 2 depending on the technical aspects (17,20,21), such as location site or temperature of electrode, and advocated the ear lobe as the site and a heated electrode of more than 42 ℃ for the temperature. However, these authors stated that the available literature attests to TCM being an accurate tool to estimate artPCO 2 to a clinically acceptable degree in the adult ICU population (22).…”

Section: Summary Of the Clinical Evidence For Tcpco 2 As A Reliable Amentioning

confidence: 99%

Transcutaneous PCO2 monitoring in critically ill patients: update and perspectives

Mari¹,

Nougué²,

Matéo³

et al. 2019

J. Thorac. Dis

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The physiology of venous and tissue CO 2 monitoring has a long and well-established physiological background, leading to the technological development of different tissue capnometric devices, such as transcutaneous capnometry monitoring (TCM). To outline briefly, measuring transcutaneous PCO 2 (tcPCO 2) depends on at least three main phenomena: (I) the production of CO 2 by tissues (VCO 2), (II) the removal of CO 2 from the tissues by perfusion (wash-out phenomenon), and (III) the reference value of CO 2 at tissue inlet represented by arterial CO 2 content (approximated by arterial PCO 2 , or artPCO 2). For this reason, there are, at present, roughly two clinical uses for tcPCO 2 measurement: a respiratory approach where tcPCO 2 is likely to estimate and non-invasively track artPCO 2 ; and a hemodynamic underestimate use where tcPCO 2 can reflect tissue perfusion, summarized by a so-called "tc-art PCO 2 gap". Recent research shows that these two uses are not incompatible and could be combined. The spectrum of indications and validation studies in ICUs is summarized in this review to give a survey of the potential applications of TCM in critically ill patients, focusing mainly on its potential (micro)circulatory monitoring contribution. We strongly believe that the greatest benefit of measuring tcPCO 2 is not to only to estimate artPCO 2 , but also to quantify the gap between these two values, which can then help clinicians continuously and noninvasively assess both respiratory and hemodynamic failures in critically ill patients.

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Prospective, observational study investigating the level of agreement between transcutaneous and invasive carbon dioxide measurements in critically ill emergency department patients

Farenden,

Chung,

Cui

et al. 2023

Emerg Med J

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BackgroundTranscutaneous carbon dioxide (Ptcco2) measurement is a non-invasive surrogate marker for arterial carbon dioxide (Paco2), which requires invasive arterial blood sampling. Use of Ptcco2has been examined in different clinical settings, however, most existing evidence in the adult emergency department (ED) setting shows insufficient agreement between the measurements. This study assessed the level of agreement between Ptcco2and Paco2in undifferentiated adult ED patients across multiple timepoints.MethodsThis prospective observational study (study period 2020–2021) assessed paired Ptcco2and Paco2measurements at four consecutive timepoints (0, 30, 60 and 90 min) in adult (aged 18 years or over) Australian ED patients requiring hospital admission and arterial catheter insertion. Agreement between the pairs was assessed using Bland-Altman analysis. It was prospectively determined by expert consensus that limits of ±4 mm Hg would be a clinically acceptable level of agreement between Ptcco2and Paco2.ResultsDuring the study period 168 paired Ptcco2and Paco2readings were taken from 42 adult ED patients. Bland-Altman analysis showed a mean Ptcco2reading 3.85 mm Hg higher than Paco2,although at each timepoint the 95% CIs breached the limit of 4 mm Hg difference. In addition, only 66% (111/168) of results fell within the clinically acceptable range.ConclusionThe level of agreement between Ptcco2and Paco2measurements may not be sufficiently precise for the adoption of Ptcco2monitoring in patients presenting to the ED.

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Erratum: Concordance and limits between transcutaneous and arterial carbon dioxide pressure in emergency department patients with acute respiratory failure: a single-center, prospective, and observational study

Cited by 3 publications

References 27 publications

The utility of transcutaneous carbon dioxide measurements in the emergency department: A prospective cohort study

The utility of transcutaneous carbon dioxide measurements in the emergency department: A prospective cohort study

Transcutaneous PCO2 monitoring in critically ill patients: update and perspectives

Prospective, observational study investigating the level of agreement between transcutaneous and invasive carbon dioxide measurements in critically ill emergency department patients

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