Evaluation of a combined transcutaneous carbon dioxide pressure and pulse oximetry sensor in adult sheep and dogs.

OBJECTIVE: To evaluate a combined transcutaneous carbon dioxide pressure (tcPCO(2)) and pulse oximetry sensor in sheep and dogs. ANIMALS: 13 adult sheep and 11 adult dogs. PROCEDURES: During inhalation anesthesia, for the first 10 minutes following sensor placement, arterial blood gas was analyzed and tcPCO(2) was recorded every 2 minutes. Subsequently, the animals were hyper-, normo-, and hypoventilated. The simultaneously obtained tcPCO(2) and PaCO(2) values were analyzed by use of Bland-Altman statistical analysis. RESULTS: Mean +/- SD overall difference between tcPCO(2) and PaCO(2) 10 minutes after sensor application was 13.3 +/- 8.4 mm Hg in sheep and 8.9 +/- 12 mm Hg in dogs. During hyper-, normo-, and hypoventilation, mean difference (bias) and precision (limits of agreement [bias +/- 2 SD]) between tcPCO(2) and PaCO(2) values were 13.2 +/- 10.4 mm Hg (limits of agreement, -7.1 and 33.5 mm Hg) in sheep and 10.6 +/- 10.5 mm Hg (limits of agreement, -9.9 and 31.2 mm Hg) in dogs, respectively. Changes in PaCO(2) induced by different ventilation settings were detected by the tcPCO(2) sensor with a lag (response) time of 4.9 +/- 3.5 minutes for sheep and 6.2 +/- 3.6 minutes for dogs. CONCLUSIONS AND CLINICAL RELEVANCE: The tcPCO(2) sensor overestimated PaCO(2) in sheep and dogs and followed changes in PaCO(2) with a considerable lag time. The tcPCO(2) sensor might be useful for noninvasive monitoring of changes but cannot be used as a surrogate measure for PaCO(2).

Performance of a digital PCO2/SPO2 ear sensor.

OBJECTIVE: For determining the adequacy of ventilation, conventional pulse oximetry should be amended by PaCO2 (= arterial carbon dioxide partial pressure). This study investigates the precision of carbon dioxide measurements of the first digital ear-clip sensor providing continuous non-invasive monitoring of PaCO2, SpO2 (= functional arterial oxygen saturation as estimated with a pulse oximeter) and pulse rate and compares it to two conventional analog oximeters. METHODS: 30 hypoxemia episodes in 6 adult volunteers were investigated in a standardized protocol. EQUIPMENT: Masimo analog finger sensor, Nellcor analog ear sensor, SenTec digital ear sensor. RESULTS: The difference between PCO2 data (= PaCO2 estimated from the measured PcCO2 based on an algorithm by Severinghaus) (PcCO2 = cutaneous carbon dioxide pressure) and the PaCO2 is clinically unimportant. Therefore, we suggest, the two methods of estimating patient's carbon dioxide status can be used interchangeably. CONCLUSIONS: Combined digital SpO2/ PcCO2 ear sensors are very promising to allow for a fast and reliable monitoring of patient's oxygenation, hyper-/hypocapnia and ventilation with one single non-invasive probe. Optimal primary signal processing--amplification and digitalisation within the probe--allow for fast and reliable downstream signal processing algorithms. The resulting short SpO2 response times give the medical staff more time to take appropriate actions.