Transcutaneous Carbon Dioxide Monitoring More Accurately Detects Hypercapnia than End-Tidal Carbon Dioxide Monitoring during Non-Intubated Video-Assisted Thoracic Surgery: A Retrospective Cohort Study
- 주제(키워드) transcutaneous carbon dioxide monitoring , end-tidal carbon dioxide monitoring , hypercapnia , non-intubated video-assisted thoracoscopic surgery
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Lee, Hyun Jung; Woo, Jae Hee; Cho, Sooyoung] Ewha Womans Univ, Coll Med, Dept Anesthesiol & Pain Med, 260 Gonghang daero, Seoul 07804, South Korea; [Moon, Sunyoung] Ewha Womans Univ Mokdong Hosp, Dept Anesthesiol & Pain Med, 1071 Anyangcheon ro, Seoul 07985, South Korea; [Sung, Sook Whan] Ewha Womans Univ, Seoul Hosp, Dept Thorac & Cardiovasc Surg, 260 Gonghang daero, Seoul 07804, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 MDPI
- 발행년도 2023
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000204256
- 본문언어 영어
- Published As https://doi.org/10.3390/jcm12041706
초록/요약
Transcutaneous carbon dioxide (PtcCO(2)) monitoring is known to be effective at estimating the arterial partial pressure of carbon dioxide (PaCO2) in patients with sedation-induced respiratory depression. We aimed to investigate the accuracy of PtcCO(2) monitoring to measure PaCO2 and its sensitivity to detect hypercapnia (PaCO2 > 60 mmHg) compared to nasal end-tidal carbon dioxide (PetCO(2)) monitoring during non-intubated video-assisted thoracoscopic surgery (VATS). This retrospective study included patients undergoing non-intubated VATS from December 2019 to May 2021. Datasets of PetCO(2), PtcCO(2), and PaCO2 measured simultaneously were extracted from patient records. Overall, 111 datasets of CO2 monitoring during one-lung ventilation (OLV) were collected from 43 patients. PtcCO(2) had higher sensitivity and predictive power for hypercapnia during OLV than PetCO(2) (84.6% vs. 15.4%, p < 0.001; area under the receiver operating characteristic curve; 0.912 vs. 0.776, p = 0.002). Moreover, PtcCO(2) was more in agreement with PaCO2 than PetCO(2), indicated by a lower bias (bias +/- standard deviation; -1.6 +/- 6.5 mmHg vs. 14.3 +/- 8.4 mmHg, p < 0.001) and narrower limit of agreement (-14.3-11.2 mmHg vs. -2.2-30.7 mmHg). These results suggest that concurrent PtcCO(2) monitoring allows anesthesiologists to provide safer respiratory management for patients undergoing non-intubated VATS.
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