ISSN:
1432-1238
Keywords:
Key words Monitoring
;
Blood gases
;
PaO2
;
pH
;
PaCO2
;
Arterial catheters
;
Radial artery
;
Oxygen electrodes
;
Fiberoptic sensors
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objective: To evaluate the in vivo performance of a continuous, intra-arterial, multiparameter blood-gas sensor containing a thermocouple, miniaturized polarographic oxygen electrode, as well as fiberoptic pH and pCO2 sensors. Design: Prospective, multicenter study comparing pH, PaCO2, and PaO2 measurements from the intra-arterial sensor with those obtained from a conventional, laboratory blood-gas monitor. Setting: Intensive care units in three academic medical centers. Patients: Adult ICU patients (n=26) with a clinical need for a radial artery catheter and frequent monitoring of arterial blood gases for ≥3 days. Interventions: All patients had the multiparameter intra-arterial sensor placed through a 20-gauge catheter into the radial artery. Every 4 h, or more frequently if clinically indicated, a blood-gas sample was withdrawn from the radial artery catheter and sent to the laboratory for analysis using a conventional laboratory blood-gas analyzer. Immediately prior to withdrawal of the arterial blood, values for pH, PaCO2, and PaO2 from the multiparameter intra-arterial sensor were recorded. Measurements and main results: The multiparameter sensor was placed into 26 patients. In 7 of the patients, premature discontinuation of monitoring was necessary because of dampening of the pressure tracing, difficulty in withdrawing blood from the arterial catheter, or bending of the extra-arterial fiberoptic channel owing to the cable being inadequately secured (mean monitoring time in these 7 patients: 40.6±25.7 h). In the other 19 patients, monitoring was continued until no longer clinically indicated. In these patients, a total of 341 data sets was collected, with the average length of monitoring being 69.9±37.9 h (range 22.0 to 57.9 h). Comparison of the sensor values with those from the blood-gas analyzer showed bias and precision values of 0.006 and 0.026 for arterial pH−1.19% and 12.54% for PaO2, and 1.28 mmHg and 2.48 mmHg for PaCO2, respectively. No complications were associated with the intra-arterial sensor. Conclusions: Clinical performance of this intra-arterial, multiparameter blood-gas sensor demonstrated stability, consistency, and accuracy comparable to laboratory blood-gas analyzers. The present multiparameter, intravascular blood-gas sensor, when inserted in the radial artery, can provide stable and accurate monitoring of pH, PaCO2, and PaO2 over clinically relevant periods of as long as 6 days in the critical care setting.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01712177
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