Objectives
To study the accuracy of three devices for measuring transcutaneous CO2 tension in critically ill children.
Methods
A prospective study comparing the values from three transcutaneous CO2 monitors (SenTec®, TOSCA 500®, and TINA TCM3®) with simultaneous arterial CO2 (PaCO2) and end‐tidal CO2 (EtCO2) values. Clinical data were collected from the patients. Influence of core‐skin temperature gradient and doses of inotropic drugs was evaluated.
Results
There were 62 samples from 41 critically ill children with ages between 2 and 192 months (median, 18.5 months) and weights between 3.1 and 72 kg (median, 9 kg). The median PaCO2 was 42.5 mmHg (range, 28–85 mmHg). Transcutaneous CO2 (PtcCO2) values correlated better with PaCO2 than with EtCO2. The correlation coefficient between PaCO2 and PtCO2 was 0.833 with the TINA TCM3® monitor, 0.931 with the SenTec® monitor, and 0.765 with the TOSCA 500® monitor. The mean (SD) differences between the PaCO2 and PtcCO2 were 4.5 (3.7) mmHg, 4.3 (3.8) mmHg, and 5.6 (5.1) mmHg, respectively, with the three monitors, and the differences between the PaCO2 and PtcCO2 were less than 7.5 mmHg in 77.7%, 81.2%, and 67.7% of the samples. Bland–Altman analysis showed a precision of ±11.5 mmHg for TINA TCM3® monitor, ±10.6 mmHg for SenTec® monitor, and ±14.8 mmHg for TOSCA® monitor. No influence of core‐skin temperature gradient and inotropic index on the differences between PaCO2 and PtcCO2 was observed.
Conclusions
The three transcutaneous CO2 monitors have an acceptable correlation with arterial CO2 tension and can be useful in critically ill children. Pediatr Pulmonol. 2010; 45:481–486. © 2010 Wiley‐Liss, Inc.