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Noninvasive monitoring of carbon dioxide in tracheostomized patients during weaning

Friederike Sophie Magnet, Sarah Schwarz, Wolfram Windisch, Jan Hendrik Storre
European Respiratory Journal 2015 46: PA2165; DOI: 10.1183/13993003.congress-2015.PA2165
Friederike Sophie Magnet
Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University Hospital, Cologne, Germany
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Sarah Schwarz
Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University Hospital, Cologne, Germany
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Wolfram Windisch
Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University Hospital, Cologne, Germany
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Jan Hendrik Storre
Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University Hospital, Cologne, Germany
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Abstract

Introduction: Gas exchange monitoring in patients undergoing weaning from mechanical ventilation (MV) is essential and a continuous-noninvasive method is desirable.

Aims and Objectives: Method comparison of PCO2 between gold standard ABG and noninvasive PCO2-assessment via end-tidal PCO2- (PetCO2) and transcutaneous PCO2-monitoring (PtcCO2) in tracheostomized patients during invasive MV.

Methods: PetCO2 and PtcCO2 was monitored over a period of 60min during MV. PaCO2-analysis was performed at beginning, at 30min and 60min. Method comparison by Bland and Altman was performed: PetCO2 versus PaCO2, PtcCO2 versus PaCO2 and PetCO2 versus PtcCO2.

Results: 62 patients were included and 60 completed the study with the following underlying diseases: COPD (n=30), neurological/neuromuscular (n=17), OHS (n=5), congestive heart failure (n=4), pneumonia (n=3) and kyphoskoliosis (n=1). Mean PaCO2 was 42,4±8,6 mmHg, PetCO2 36,5±7,5 mmHg and PtcCO2 41,7±8,7 mmHg during 60min of MV. Bland and Altman method comparison is shown in Table.

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Method comparison of PCO2-measurements

Conclusions: Both noninvasive methods of PCO2-measurements can not completely substitute PaCO2 measurements in patients undergoing weaning from MV. However, PtcCO2 showed more favorable results in method comparison to the gold standard PaCO2 compared to PetCO2. Following, transcutaneous but not end-tidal analysis of gas exchange is suggested to be an appropriate surrogate for AGB.

  • Mechanical ventilation - weaning
  • Gas exchange
  • Intensive care
  • Copyright ©ERS 2015
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Noninvasive monitoring of carbon dioxide in tracheostomized patients during weaning
Friederike Sophie Magnet, Sarah Schwarz, Wolfram Windisch, Jan Hendrik Storre
European Respiratory Journal Sep 2015, 46 (suppl 59) PA2165; DOI: 10.1183/13993003.congress-2015.PA2165

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Noninvasive monitoring of carbon dioxide in tracheostomized patients during weaning
Friederike Sophie Magnet, Sarah Schwarz, Wolfram Windisch, Jan Hendrik Storre
European Respiratory Journal Sep 2015, 46 (suppl 59) PA2165; DOI: 10.1183/13993003.congress-2015.PA2165
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