Abstract
This study investigated the accuracy, drift, and clinical usefulness of a new optical transcutaneous oxygen tension (tcPO2) measuring technique, combined with a conventional electrochemical transcutaneous carbon dioxide (tcPCO2) measurement and reflectance pulse oximetry in the novel transcutaneous OxiVenT™ Sensor. In vitro gas studies were performed to measure accuracy and drift of tcPO2 and tcPCO2. Clinical usefulness for tcPO2 and tcPCO2 monitoring was assessed in neonates. In healthy adult volunteers, measured oxygen saturation values (SpO2) were compared with arterially sampled oxygen saturation values (SaO2) during controlled hypoxemia. In vitro correlation and agreement with gas mixtures of tcPO2 (r = 0.999, bias 3.0 mm Hg, limits of agreement − 6.6 to 4.9 mm Hg) and tcPCO2 (r = 0.999, bias 0.8 mm Hg, limits of agreement − 0.7 to 2.2 mm Hg) were excellent. In vitro drift was negligible for tcPO2 (0.30 (0.63 SD) mm Hg/24 h) and highly acceptable for tcPCO2 (− 2.53 (1.04 SD) mm Hg/12 h). Clinical use in neonates showed good usability and feasibility. SpO2-SaO2 correlation (r = 0.979) and agreement (bias 0.13%, limits of agreement − 3.95 to 4.21%) in healthy adult volunteers were excellent. The investigated combined tcPO2, tcPCO2, and SpO2 sensor with a new oxygen fluorescence quenching technique is clinically usable and provides good overall accuracy and negligible tcPO2 drift. Accurate and low-drift tcPO2 monitoring offers improved measurement validity for long-term monitoring of blood and tissue oxygenation.Graphical abstract
Highlights
The OxiVenTTM Sensor is the first transcutaneous sensor in which an optical tcPO2 measurement is combined with an electrochemical Stow-Severinghaus-type tcPCO2 measurement and reflective pulse oximetry (Fig. 1)
Drift of tcPCO2 is notably highest during the first hour, tcPO2 drift is not affected
Four examples of clinical events were selected from patient files, are shown in Fig. 3, and include tcPO2 and tcPCO2 data, as well as the SpO2 data obtained from standard of care pulse oximetry
Summary
Transcutaneous blood gas monitoring is based on the diffusion of oxygen (O2) and carbon dioxide (CO2) from the blood to the skin surface [1]. Transcutaneous blood gas sensors locally heat the skin to induce vasodilation, resulting in an increase in supplied O2 and clearance of CO2 [2, 3]. As a consequence the measurement of transcutaneous oxygen (tcPO2) [8] requires relatively high sensor temperatures of 43 to 44 °C [9] for tcPO2 to correlate with arterial oxygen tension (PaO2), which due to skin thickness only results in tcPO2 values approaching PaO2 in infants and young children [10,11,12].
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