Advantages of Transcutaneous CO2 over End-Tidal CO2 for Sleep Monitoring
Evaluation of a patient’s respiratory and ventilatory status is often based on intermittent arterial samples that are neither practical during sleep nor offer continuous blood gas monitoring. End-tidal CO2 (ETCO2) monitoring is used to indicate patient ventilation status as it reflects trends of arterial pCO2 (PaCO2).
The accuracy of this technique depends on sampling undiluted alveolar gas during expiration, but factors like tachypnea or increased physiologic dead space may result in an underestimation of the PaCO2.
Severe airway obstruction, mouth breathing or limitation of expiratory flow, etc. may also influence the ETCO2 accuracy. Transcutaneous carbon dioxide monitoring (tcpCO2) shows trends of PaCO2. The technique is widely used during and after non-invasive ventilation (NIV) and during sleep on adults as well as on neonatal and pediatric patients.
Several studies document that patients with respiratory diseases involving shunts or V/Q mismatches are more accurately monitored by tcpCO2 than by ETCO2.
This webinar will:
- Summarize the CO2 measurement landscape and distinguish between the various methods currently in use in the Sleep lab
- Identify the advances in the technology of Trancutaneous CO2 monitoring
- Compare the detection accuracy and trend prediction capabilities of transcutaneous CO2 vs. the end-tidal method
- Appraise the benefits of early detection of CO2 trending to a cross-section of patients in the Sleep lab
Brian Schultz, RPSUT
The Children's Hospital of Philadelphia