Transcutaneous paCO2 Monitoring: Difference between revisions
From Guide to YKHC Medical Practices
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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> | # 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 | ## Any situation where monitoring for apnea or any rapid changes in paCO<sub>2</sub>. | ||
== Device == | == Device == | ||
Revision as of 17:15, 13 March 2023
Transcutaneous CO2 (TC-CO2) monitors function by measuring the CO2 which diffuses out the skin. Modern TC-CO2 monitors are a highly accurate, non-invasive method for estimating paCO2.[1]
Primary Purpose
YKDRH obtained TC-CO2 monitors for the purpose of following paCO2 trends in patients receiving high-flow nasal cannula or non-invasive ventilation (i.e. CPAP/BiPAP). This was necessary because end-tidal CO2 monitoring is not compatible with these interventions.
Important Points
- Applicable for all age groups (including extremely premature neonates).
- Initial reading requires approximately five minutes to establish.
- The TC-CO2 reading at any given time reflects the paCO2 from several minutes prior.
- TC-CO2 measures paCO2 trends; it DOES NOT measure instantaneous levels. Therefore, TC-CO2 IS NOT an acceptable substitute for ET-CO2 in these situations:
- Confirmation of ET-tube placement.
- CPR (neither for CPR adequacy nor ROSC identification).
- Respiratory monitoring during sedation.
- Any situation where monitoring for apnea or any rapid changes in paCO2.
Device
YKDRH has acquired the Sentec Digital Monitoring System.
The Sentec devices provides monitoring of:
- Instantaneous oximetry
- Instantaneous heart rate
- Trending of paCO2
Resources
Instructional Videos:
- Neonatal Sensor Application for the Sentec Digital Transcutaneous Monitoring System
- Sensor Application Adult Cheek for the Sentec Digital Transcutaneous Monitoring System
REFERENCES
- ↑ Nassar BS, Schmidt GA. 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.
