AARC clinical practice guideline: Transcutaneous monitoring of carbon dioxide and oxygen: 2012

Ruben D. Restrepo, Keith R. Hirst, Leonard Wittnebel, Richard Wettstein

Research output: Contribution to journalReview article

48 Scopus citations

Abstract

An electronic literature search for articles published between January 1990 and September 2011 was conducted by using the PubMed, CINAHL, SCOPUS, and Cochrane Library databases. The update of this clinical practice guideline is the result of reviewing a total of 124 articles: 3 randomized controlled trials, 103 prospective trials, 1 retrospective study, 3 case studies, 11 review articles, 2 surveys and 1 consensus paper on transcutaneous monitoring (TCM) for PtcO2 and PtcCO2. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria: (1) Although PtcCO2 has a good correlation with PaCO2 and is a reliable method to evaluate plasma CO2 levels, it is recommended that arterial blood gas values be compared to transcutaneous readings taken at the time of arterial sampling, in order to verify the transcutaneous values, and periodically as dictated by the patient's clinical condition. (2) It is suggested that PtcCO2 may be used in clinical settings where monitoring the adequacy of ventilation is indicated. (3) It is suggested that PtcO2 and PtcCO2 may be used in determining the adequacy of tissue perfusion and monitoring of reperfusion. (4) It is suggested that TCM should be avoided in the presence of increased thickness or edema of the skin and/or subcutaneous tissue where the sensor is applied. (5) It is recommended that sites used for a TCM be changed as often as necessary and that they be alternated and observed to avoid thermal injury. Manufacturer recommendations should be followed.

Original languageEnglish (US)
Pages (from-to)1955-1962
Number of pages8
JournalRespiratory care
Volume57
Issue number11
DOIs
StatePublished - Nov 1 2012

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Keywords

  • Clinical practice guidelines
  • Hyperbaric oxygen therapy
  • Reperfusion
  • Transcutaneous carbon dioxide
  • Transcutaneous carbon dioxide monitoring
  • Transcutaneous monitoring
  • Transcutaneous oxygen
  • Transcutaneous oxygen monitoring

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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