Transcutaneous paCO2 Monitoring - Revision history

LiamG: /* Resources */

2023-03-31T00:14:42Z

Resources

← Older revision		Revision as of 00:14, 31 March 2023
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	: [https://yk-health.org/wiki/File:Transcutaneous_CO2_monitor_SDMS_InstructionManual_EN.pdf Sentec Instruction Manual]		: [https://yk-health.org/wiki/File:Transcutaneous_CO2_monitor_SDMS_InstructionManual_EN.pdf Sentec Instruction Manual]
	'''Instructional Videos:'''		'''Instructional Videos:'''
	: [https://www.youtube.com/watch?v=7d7XNtQNllA ~~Neonatal~~ Sensor Application for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7d7XNtQNllA Sensor Application Neonatal for the Sentec Digital Transcutaneous Monitoring System]
	: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]
	: [https://www.youtube.com/watch?v=7PeoOWAtWss Sensor Application Adult Upper Arm for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7PeoOWAtWss Sensor Application Adult Upper Arm for the Sentec Digital Transcutaneous Monitoring System]

LiamG: /* Resources */

2023-03-31T00:14:17Z

Resources

← Older revision		Revision as of 00:14, 31 March 2023
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	: [https://www.youtube.com/watch?v=7d7XNtQNllA Neonatal Sensor Application for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7d7XNtQNllA Neonatal Sensor Application for the Sentec Digital Transcutaneous Monitoring System]
	: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]
	: [https://www.youtube.com/watch?v=~~7PeoOWAtWssSensor~~ Application Adult Upper Arm for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7PeoOWAtWss Sensor Application Adult Upper Arm for the Sentec Digital Transcutaneous Monitoring System]
	: [https://www.youtube.com/watch?v=DLWEH-2VHZc Changing the Sensor Membrane for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=DLWEH-2VHZc Changing the Sensor Membrane for the Sentec Digital Transcutaneous Monitoring System]
	: [https://www.youtube.com/watch?v=zCc4JZsfKZM Sentec Digital Transcutaneous Monitoring System Demonstration]		: [https://www.youtube.com/watch?v=zCc4JZsfKZM Sentec Digital Transcutaneous Monitoring System Demonstration]

LiamG at 00:13, 31 March 2023

2023-03-31T00:13:29Z

← Older revision		Revision as of 00:13, 31 March 2023
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	: [https://www.youtube.com/watch?v=7d7XNtQNllA Neonatal Sensor Application for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7d7XNtQNllA Neonatal Sensor Application for the Sentec Digital Transcutaneous Monitoring System]
	: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]
			: [https://www.youtube.com/watch?v=7PeoOWAtWssSensor Application Adult Upper Arm for the Sentec Digital Transcutaneous Monitoring System]
			: [https://www.youtube.com/watch?v=DLWEH-2VHZc Changing the Sensor Membrane for the Sentec Digital Transcutaneous Monitoring System]
			: [https://www.youtube.com/watch?v=zCc4JZsfKZM Sentec Digital Transcutaneous Monitoring System Demonstration]

	<br>		<br>
	'''PubMed Searches:'''		'''PubMed Searches:'''

AndyS at 23:04, 14 March 2023

2023-03-14T23:04:55Z

← Older revision		Revision as of 23:04, 14 March 2023
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	## Respiratory monitoring during sedation.		## Respiratory monitoring during sedation.
	## Any situation where monitoring for apnea or any rapid changes in paCO<sub>2</sub>.		## Any situation where monitoring for apnea or any rapid changes in paCO<sub>2</sub>.
			# The accuracy of end-tidal CO<sub>2</sub> as an estimate of paCO<sub>2</sub> is largely dependent upon how closely a patient's lung function matches an ideal lung. For patients who are intubated for non-respiratory issues, their lung function should pretty closely approximate an ideal lung, and thus end-tidal CO<sub>2</sub> should estimate paCO<sub>2</sub> with reasonable accuracy. But for patients with lung processes which create V/Q mismatches, end-tidal CO<sub>2</sub> is not a good estimate of paCO<sub>2</sub>. In such situations, TC-CO<sub>2</sub> provides a MUCH MORE ACCURATE estimate paCO<sub>2</sub>.<ref name="Nassar2017"/> Thus, if paCO<sub>2</sub> requires monitoring in patients with ARDS, bronchiolitis, pneumonia, etc., TC-CO<sub>2</sub> should be considered regardless of the type of respiratory support the patient is receiving (i.e. none, high-flow, or intubated). In such a situation, an intubated patient might be monitored with end-tidal CO<sub>2</sub> to watch for apnea and TC-CO<sub>2</sub> to assess adequacy of ventilation over time.
			<br>

	== Device ==		== Device ==

AndyS at 21:52, 14 March 2023

2023-03-14T21:52:27Z

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	Transcutaneous CO<sub>2</sub> (TC-CO<sub>2</sub>) monitors function by measuring the CO<sub>2</sub> which diffuses out the skin. Modern TC-CO<sub>2</sub> monitors are a highly accurate, non-invasive method for estimating paCO<sub>2</sub>.<ref name="Nassar2017">Nassar BS, Schmidt GA. [https://doi.org/10.1513/AnnalsATS.201701-034FR '''Estimating Arterial Partial Pressure of Carbon Dioxide in Ventilated Patients: How Valid Are Surrogate Measures?'''] Ann Am Thorac Soc. 2017 Jun;14(6):1005-1014. doi: 10.1513/AnnalsATS.201701-034FR. PMID: 28570147.</ref><br>		Transcutaneous CO<sub>2</sub> (TC-CO<sub>2</sub>) monitors function by measuring the CO<sub>2</sub> which diffuses out the skin. Modern TC-CO<sub>2</sub> monitors are a highly accurate, non-invasive method for estimating paCO<sub>2</sub>.<ref name="Nassar2017">Nassar BS, Schmidt GA. [https://doi.org/10.1513/AnnalsATS.201701-034FR '''Estimating Arterial Partial Pressure of Carbon Dioxide in Ventilated Patients: How Valid Are Surrogate Measures?'''] Ann Am Thorac Soc. 2017 Jun;14(6):1005-1014. doi: 10.1513/AnnalsATS.201701-034FR. PMID: 28570147.</ref><br>
			<br>
			[[File:Sentec.PNG\|left]]
			<br clear=all>
	<br>		<br>

AndyS at 18:38, 13 March 2023

2023-03-13T18:38:09Z

← Older revision		Revision as of 18:38, 13 March 2023
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	: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]		: [https://www.youtube.com/watch?v=7HX7dgqieaM Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System]
	<br>		<br>
			'''PubMed Searches:'''
			: [https://pubmed.ncbi.nlm.nih.gov/?term=(%22transcutaneous%20co2%22%5BTitle%5D%20OR%20%22transcutaneous%20carbon%20dioxide%22%5BTitle%5D)%20AND%20(infant%5BTitle%5D%20OR%20neonat%5BTitle%5D%20OR%20child%5BTitle%5D) ("transcutaneous co2"[Title<nowiki>]</nowiki> OR "transcutaneous carbon dioxide"[Title<nowiki>]</nowiki>) AND (infant[Title<nowiki>]</nowiki> OR neonat[Title<nowiki>]</nowiki> OR child[Title<nowiki>]</nowiki>)]
	<br>		<br>

	== REFERENCES ==		== REFERENCES ==
	‎<references />		‎<references />

AndyS at 18:36, 13 March 2023

2023-03-13T18:36:11Z

← Older revision		Revision as of 18:36, 13 March 2023
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	The Sentec devices provides monitoring of:		The Sentec devices provides monitoring of:
	# Instantaneous oximetry (with an adjustable duration trend line)		# Instantaneous oximetry (with an adjustable duration trend line)
	# Instantaneous heart rate		# Instantaneous heart rate (with an adjustable duration trend line)
	# ~~Trending of~~ paCO<sub>2</sub> (with an adjustable duration trend line)		# Delayed paCO<sub>2</sub> (with an adjustable duration trend line)

	== Resources ==		== Resources ==

AndyS at 18:31, 13 March 2023

2023-03-13T18:31:48Z

← Older revision		Revision as of 18:31, 13 March 2023
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	YKDRH has acquired the '''Sentec''' Digital Monitoring System.<br>		YKDRH has acquired the '''Sentec''' Digital Monitoring System.<br>
	The Sentec devices provides monitoring of:		The Sentec devices provides monitoring of:
	# Instantaneous oximetry		# Instantaneous oximetry (with an adjustable duration trend line)
	~~# Instantaneous heart rate~~ (with an adjustable duration trend line)		# Instantaneous heart rate
	# Trending of paCO<sub>2</sub> (with an adjustable duration trend line)		# Trending of paCO<sub>2</sub> (with an adjustable duration trend line)

AndyS at 18:29, 13 March 2023

2023-03-13T18:29:57Z

← Older revision		Revision as of 18:29, 13 March 2023
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	Transcutaneous CO<sub>2</sub> (TC-CO<sub>2</sub>) monitors function by measuring the CO<sub>2</sub> which diffuses out the skin. Modern TC-CO<sub>2</sub> monitors are a highly accurate, non-invasive method for estimating paCO<sub>2</sub>.<ref>Nassar BS, Schmidt GA. [https://doi.org/10.1513/AnnalsATS.201701-034FR '''Estimating Arterial Partial Pressure of Carbon Dioxide in Ventilated Patients: How Valid Are Surrogate Measures?'''] Ann Am Thorac Soc. 2017 Jun;14(6):1005-1014. doi: 10.1513/AnnalsATS.201701-034FR. PMID: 28570147.</ref><br>		Transcutaneous CO<sub>2</sub> (TC-CO<sub>2</sub>) monitors function by measuring the CO<sub>2</sub> which diffuses out the skin. Modern TC-CO<sub>2</sub> monitors are a highly accurate, non-invasive method for estimating paCO<sub>2</sub>.<ref name="Nassar2017">Nassar BS, Schmidt GA. [https://doi.org/10.1513/AnnalsATS.201701-034FR '''Estimating Arterial Partial Pressure of Carbon Dioxide in Ventilated Patients: How Valid Are Surrogate Measures?'''] Ann Am Thorac Soc. 2017 Jun;14(6):1005-1014. doi: 10.1513/AnnalsATS.201701-034FR. PMID: 28570147.</ref><br>
	<br>		<br>

	== Primary Purpose ==		== Primary Purpose ==
	YKDRH obtained TC-CO<sub>2</sub> monitors for the purpose of ~~following~~ paCO<sub>2</sub> <u>trends</u> in patients receiving high-flow nasal cannula or non-invasive ventilation (i.e. CPAP/BiPAP). This was necessary because end-tidal CO<sub>2</sub> monitoring is not compatible with these interventions.		YKDRH obtained TC-CO<sub>2</sub> monitors for the purpose of monitoring paCO<sub>2</sub> <u>trends</u> in patients receiving high-flow nasal cannula or non-invasive ventilation (i.e. CPAP/BiPAP). This was necessary because end-tidal CO<sub>2</sub> monitoring is not compatible with these interventions.


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	# Applicable for all age groups (including extremely premature neonates).		# Applicable for all age groups (including extremely premature neonates).
	# Initial reading requires approximately five minutes to establish.		# Initial reading requires approximately five minutes to establish.
	# ~~The~~ TC-CO<sub>2</sub> reading at any given time reflects the paCO<sub>2</sub> from ~~several~~ minutes prior.		# TC-CO<sub>2</sub> is '''substantially more accurate''' than peripheral venous CO<sub>2</sub> for estimating paCO<sub>2</sub>.<ref name="Nassar2017"/>
	# TC-CO<sub>2</sub> ~~measures~~ paCO<sub>2</sub> trends; it DOES NOT measure instantaneous levels. Therefore, TC-CO<sub>2</sub> '''IS NOT''' an acceptable substitute for ET-CO<sub>2</sub> in ~~these~~ situations:		# Because CO<sub>2</sub> takes several minutes to diffuse out of the skin, the displayed TC-CO<sub>2</sub> reading at any given time reflects the paCO<sub>2</sub> from 2-4 minutes prior.
			# The tracing is a flat line (rather than the waveform created by exhaled air).
			# TC-CO<sub>2</sub> is used to follow paCO<sub>2</sub> trends; it DOES NOT measure instantaneous levels. Therefore, TC-CO<sub>2</sub> '''IS NOT''' an acceptable substitute for ET-CO<sub>2</sub> in situations such as:
	## Confirmation of ET-tube placement.		## Confirmation of ET-tube placement.
	## CPR (neither for CPR adequacy nor ROSC identification).		## CPR (neither for CPR adequacy nor ROSC identification).
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	The Sentec devices provides monitoring of:		The Sentec devices provides monitoring of:
	# Instantaneous oximetry		# Instantaneous oximetry
	# Instantaneous heart rate		# Instantaneous heart rate (with an adjustable duration trend line)
	# Trending of paCO<sub>2</sub>		# Trending of paCO<sub>2</sub> (with an adjustable duration trend line)

	== Resources ==		== Resources ==

AndyS at 17:15, 13 March 2023

2023-03-13T17:15:02Z

← Older revision		Revision as of 17:15, 13 March 2023
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	# Applicable for all age groups (including extremely premature neonates).		# Applicable for all age groups (including extremely premature neonates).
	# Initial reading requires approximately five minutes to establish.		# Initial reading requires approximately five minutes to establish.
	# TC-CO<sub>2</sub> measures paCO<sub>2</sub> trends; it DOES NOT measure instantaneous levels. Therefore, TC-CO<sub>2</sub> is NOT an acceptable substitute for ET-CO<sub>2</sub> in these situations:		# The TC-CO<sub>2</sub> reading at any given time reflects the paCO<sub>2</sub> from several minutes prior.
			# TC-CO<sub>2</sub> measures paCO<sub>2</sub> trends; it DOES NOT measure instantaneous levels. Therefore, TC-CO<sub>2</sub> '''IS NOT''' an acceptable substitute for ET-CO<sub>2</sub> in these situations:
	## Confirmation of ET-tube placement.		## Confirmation of ET-tube placement.
			## CPR (neither for CPR adequacy nor ROSC identification).
	## Respiratory monitoring during sedation.		## Respiratory monitoring during sedation.
	## Any situation where apnea ~~is a concern~~.		## Any situation where monitoring for apnea or any rapid changes in paCO<sub>2</sub>.

	== Device ==		== Device ==