Published online December 15, 2004
PEDIATRICS Vol. 115 No. 1 January 2005, pp. e64-e68 (doi:10.1542/10.1542/peds.2004-0946)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bernet-Buettiker, V.
Right arrow Articles by Weiss, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bernet-Buettiker, V.
Right arrow Articles by Weiss, M.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ELECTRONIC ARTICLE

Evaluation of a New Combined Transcutaneous Measurement of PCO2/Pulse Oximetry Oxygen Saturation Ear Sensor in Newborn Patients

Vera Bernet-Buettiker*, Maria J. Ugarte*, Bernhard Frey*, Maja Isabelle Hug*, Oskar Baenziger* and Markus Weiss{ddagger}

* Departments of Neonatology and Intensive Care
{ddagger} Anaesthesia, University Children's Hospital, Zurich, Switzerland

Objective. Arterial oxygen saturation (SaO2) and arterial carbon dioxide partial pressure (PaCO2) are 2 of the most important respiratory parameters in the treatment of critically ill neonates. Noninvasive monitoring of these parameters is desirable for continuous estimating of the respiratory status and reducing blood loss because of repeated blood gas analyses. Transcutaneous measurement of PCO2 (PtcCO2) represents a simple and noninvasive technique for continuous monitoring of ventilation. However, sensor preparation, positioning, taping, and repeated changes of the sensor location make the handling difficult and complicate its use in the neonatal care unit. Recently, a new sensor for combined assessment of pulse oximetry oxygen saturation (SpO2) and PtcCO2 has been introduced (TOSCA Monitor; Linde Medical Sensors, Basel, Switzerland). The monitor combines pulse oximetry and PtcCO2 measurement in a single ear sensor, which works at 42°C to enhance blood flow in capillaries below the sensor.

Methods. In a prospective, open, nonrandomized study of 60 ill neonates, the new ear sensor for combined assessment of SpO2 and PtcCO2 at 42°C was tested. The sensor was adapted to the ear of a neonate with a Varihesive layer (Conva Tec; Princeton, NJ). Data obtained from the ear sensor were compared with SpO2 Finger/Heel, SaO2, and PaCO2 obtained from arterial blood gas in 30 patients and with a capillary blood gas in an additional 30 patients using Bland Altman bias analysis. Data are presented as median (range).

Results. The postconceptional age of the patients was 38.3 weeks (range: 28 5/7–40 5/7) in the arterial group and 37.9 weeks (range: 29 6/7–41 0/7) in the capillary group. Age of the newborns studied was 3.5 days (range: 1–28) in the arterial blood sample group (n = 30) and 6 days (range: 2–28) in the capillary blood sample group (n = 30). Patient weight was 3.02 kg (range: 1.5–4.5) in the arterial group and 2.76 kg (range: 1.0–3.71) in the other group. Three patients had weights of <1500 g. Twenty-one of 60 patients were conventionally ventilated, 4 patients received high-frequency oscillation, and 35 were not ventilated. Mean difference (bias) and precision (2 SD of the mean difference) between PtcCO2 TOSCA and PaCO2 were –0.44 kPa (–3.21 mm Hg) and 0.82 kPa (6.02 mm Hg) and between PtcCO2 TOSCA and PcapCO2 were –0.09 kPa (–0.67 mm Hg) and 1.11 kPa (8.07 mm Hg), respectively. SpO2 assessment by the TOSCA revealed slightly higher values compared with SaO2 (bias: –0.48%), whereas SpO2 Finger/Heel values were slightly lower than SaO2 (bias: 0.52%).

Conclusion. The TOSCA monitor with the ear sensor adapted to ears of neonates allows reliable estimation of SaO2 and PaCO2. A potential benefit is the reduction in motion artifacts because of less head movement in newborns and that only a single cable leads form the patient to the monitor. In addition, the sensor is not removed for chest radiograph or for nursing the infant on his or her parent's lap. Long-term studies in a large population with continuous measurements are required to confirm these preliminary findings and to elucidate the benefits in detection of respiratory deterioration and the potential side effects of this sensor.

Key Words: noninvasive monitoring • oxygenation • pulse oximetry • carbon dioxide • neonate

Abbreviations: SaO2, arterial oxygen saturation • PaCO2, partial arterial pressure of carbon dioxide • PtcCO2, transcutaneous measurement of PCO2

Accepted Aug 23, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
S. Lacerenza, M. P. De Carolis, F. P. Fusco, G. La Torre, G. Chiaradia, and C. Romagnoli
An Evaluation of a New Combined Spo2/PtcCO2 Sensor in Very Low Birth Weight Infants
Anesth. Analg., July 1, 2008; 107(1): 125 - 129.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
E J Molloy and K Deakins
Are carbon dioxide detectors useful in neonates?
Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2006; 91(4): F295 - F298.
[Abstract] [Full Text] [PDF]