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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2001 April;67(4):325-31

language: English

Experiences with continuous intra-arterial blood gas monitoring

Menzel M., Henze D., Soukup J., Engelbrecht K., Senderreck M., Clausen T., Radke J.

From the Depart­ment of Anes­the­sio­lo­gy and Inten­sive ­Care Med­i­cine Mar­tin-­Luther-Uni­ver­sity ­Halle/Ger­ma­ny


Man­age­ment of crit­i­cal­ly ill ­patients ­requires fre­quent arte­ri­al ­blood gas anal­y­ses for assess­ing the pul­mo­nary sit­u­a­tion and adjust­ing ven­ti­la­tor set­tings and cir­cu­la­to­ry ther­a­peu­tic meas­ures. Con­tin­u­ous arte­ri­al ­blood gas anal­y­sis is a ­real-­time mon­i­tor­ing ­tool, ­which reli­ably ­detects the ­onset of ­adverse pul­mo­nary ­effects. It ­gives rap­id con­fir­ma­tion of ven­ti­la­tor set­ting chang­es and resus­ci­ta­tion and ­helps to ­ensure pre­cise adjust­ment of ther­a­py. In ­this ­study a new­ly avail­able ­fiber ­optic sen­sor ­system has ­been ­employed for con­tin­u­ous intra­ar­te­ri­al ­blood gas mon­i­tor­ing. The meas­ure­ment per­for­mance was com­pared ­with a ­bench top ­blood gas ana­lyz­er.
A pros­pec­tive ­study was per­formed enroll­ing 20 ­patients under­go­ing sur­gery. A com­par­i­son ­between inter­mit­tent ­blood gas anal­y­ses (ABL Radiom­e­ter 610) and the ­results of con­tin­u­ous ­blood gas mon­i­tor­ing (Par­a­trend 7+, Agi­lent Tech­nol.) was per­formed by simul­ta­ne­ous meas­ure­ments. Sta­tis­ti­cal anal­y­sis in agree­ment ­with the meth­od of “­Bland and Alt­man” was ­employed. Two ­case ­reports are pro­vid­ed of ­patients ­with ­Acute ­Adult Res­pir­a­to­ry Dis­tress Syn­drome and rap­id chang­es in ven­ti­la­tor set­tings.
­Over a ­range of arte­ri­al oxy­gen­a­tion ­from 10 to 50 kPa the ­bias for pO2-meas­ure­ment was 0.2 (lim­its of agree­ment 4), R2=0.9. If the arte­ri­al pO2 was high­er ­than 50 kPa the ­bias was -7 (10) kPa. PCO2-meas­ure­ment ­showed a ­bias of 0.25 (lim­its of agree­ment 0.45), R2=0.7. pH ­bias was -0.02 (lim­its of agree­ment 0.04), R2=0.7.
The Par­a­trend 7+ sen­sor ­proved to be clin­i­cal fea­sible and ­showed an ­improved pre­ci­sion in ­terms of clin­i­cal sit­u­a­tions ­with an arte­ri­al pO2 small­er ­than 50 kPa. How­ev­er, the ­results are not ­much dif­fer­ent regard­ing the find­ings ­with old­er ­systems con­sist­ing of ­hybrid tech­nol­o­gy com­bin­ing ­optodes and elec­tro­chem­i­cal oxy­gen meas­ure­ment. The advan­tag­es ­might be ­seen if the sen­sor is ­used for a peri­od ­over sev­er­al ­days in ­patients on ICU as dem­on­strat­ed by the two ­case ­reports.

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