Transcutaneous carbon dioxide monitoring to avoid hypercapnia during complex catheter ablations: a feasibility study

Abstract

Transcutaneous CO2 monitoring is feasible during complex catheter ablation and correlates with invasively obtained data. However, further development is needed to achieve the desired level of agreement.

Continuous transcutaneous carbon-dioxide monitoring to avoid hypercapnia in complex catheter ablations under conscious sedation

“…This finding was confirmed by Bland-Altman analysis. In different settings values of agreement between tpCO 2 and paCO 2 were comparable to our cohort [8,22]. Knowing, that arterial blood gas analyses are the gold standard for evaluating pCO 2 arterial values were determined additionally.…”

“…To guarantee a safe sedation invasive or non-invasive blood pressure (BP), oxygen saturation by pulse oximetry (SpO 2 ) and electrocardiogram including heart rate are monitored. Venous or arterial blood gas analysis can be performed in addition to verify SpO 2 and to detect hypercapnia [7,8]. The gold standard to determine hypercapnia is the measurement of the arterial carbon dioxide (CO 2 ) partial pressure but unlike oxygen (O 2 ) partial pressure CO 2 partial pressure in venous blood samples shows similar values to the arterial blood gas analysis.…”

“…Besides the conventional techniques, there is also the possibility of a continuous, transcutaneous evaluation of carbon-dioxide (tpCO 2 ) and transcutaneous oxygen saturation (tspO 2 ) [9]. The value of the tpCO 2 correlates well with the values of the arterial blood gas analysis [8,9]. The tpCO 2 measurement is an established tool for sedation monitoring in endoscopy, bronchoscopy and for respiratory and hemodynamic monitoring in neonatology critical care units [10][11][12][13].…”

“…The tpCO 2 measurement is an established tool for sedation monitoring in endoscopy, bronchoscopy and for respiratory and hemodynamic monitoring in neonatology critical care units [10][11][12][13]. Experience with tpCO 2 measurement during catheter ablation is very limited [8]. Decline of cardiac output, especially by spontaneous or induced tachycardias and patients with preexisting cardiac pathologies, such as reduced left ventricular pump function, coronary artery disease, and valvular disease, are conditions that are frequently found in complex electrophysiological procedures.…”