Accuracy of continuous noninvasive partial pressure of carbon dioxide monitoring in old diabetic patients undergoing general anesthesia

Abstract

Objective To evaluate the accuracy of continuous noninvasive partial pressure of carbon dioxide monitoring in the old diabetic patients undergoing general anesthesia. Methods Sixty-six old diabetic patients of both sexes, aged 65-76 yr, weighing 49-95 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective surgery under general anesthesia, were included in this study.Transcutaneous partial pressure of carbon dioxide(TcPCO2)was monitored by a noninvasive transcutaneous carbon dioxide monitor.Arterial blood samples were collected at 30 and 60 min after endotracheal intubation, partial pressure of arterial carbon dioxide(PaCO2)was monitored, and TcPCO2 and end-tidal pressure of carbon dioxide(PETCO2)were recorded.Bland-Altman analysis was used to measure the agreement. Results At 30 min after intubation, the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.3, 95% confidence interval(CI)was 1.0-1.6, and the limit of agreement was -1.1-3.7; the mean difference between PaCO2 and PETCO2 was -3.2, 95%CI: -3.6--2.8, and the limit of agreement was -6.6-0.2.At 60 min after intubation, the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.4, 95% CI was 1.1-1.7, and the limit of agreement was -1.0-3.4; the mean difference between PaCO2 and PETCO2 was -3.1, 95%CI was -3.5--2.7, and the limit of agreement was -6.7-0.5.The repeatability coefficients of PaCO2, TcPCO2 and PETCO2 were 2.1, 2.3 and 2.3, respectively, at 30 and 60 min after intubation. Conclusion Continuous noninvasive partial pressure of carbon dioxide monitoring provides good accuracy and can be used as an alternative to PaCO2 monitoring, and the accuracy is higher than that of PETCO2 for the old diabetic patients undergoing general anesthesia. Key words: Carbon dioxide; Monitoring, physiologic; Diabetes mellitus; Anesthesia, general