Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Biomedical Engineering / Biomedizinische Technik

Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering and the German Society of Biomaterials

Editor-in-Chief: Dössel, Olaf

Editorial Board: Augat, Peter / Habibović, Pamela / Haueisen, Jens / Jahnen-Dechent, Wilhelm / Jockenhoevel, Stefan / Knaup-Gregori, Petra / Lenarz, Thomas / Leonhardt, Steffen / Plank, Gernot / Radermacher, Klaus M. / Schkommodau, Erik / Stieglitz, Thomas / Boenick, Ulrich / Jaramaz, Branislav / Kraft, Marc / Lenthe, Harry / Lo, Benny / Mainardi, Luca / Micera, Silvestro / Penzel, Thomas / Robitzki, Andrea A. / Schaeffter, Tobias / Snedeker, Jess G. / Sörnmo, Leif / Sugano, Nobuhiko / Werner, Jürgen /

6 Issues per year


IMPACT FACTOR 2017: 1.096
5-year IMPACT FACTOR: 1.492

CiteScore 2017: 0.48

SCImago Journal Rank (SJR) 2017: 0.202
Source Normalized Impact per Paper (SNIP) 2017: 0.356

Online
ISSN
1862-278X
See all formats and pricing
More options …
Volume 63, Issue 6

Issues

Volume 57 (2012)

Response time of indirectly accessed gas exchange depends on measurement method

Jakub RaflORCID iD: http://orcid.org/0000-0001-5102-9354 / Filip Kulhanek
  • Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Petr Kudrna
  • Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Vaclav Ort
  • Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Karel Roubik
  • Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-08-12 | DOI: https://doi.org/10.1515/bmt-2017-0070

Abstract

Noninvasive techniques are routinely used for assessment of tissue effects of lung ventilation. However, comprehensive studies of the response time of the methods are scarce. The aim of this study was to compare the response time of noninvasive methods for monitoring of gas exchange to sudden changes in the composition of the inspired gas. A prospective experimental study with 16 healthy volunteers was conducted. A ventilation circuit was designed that enabled a fast change in the composition of the inspiratory gas mixture while allowing spontaneous breathing. The volunteers inhaled a hypoxic mixture, then a hypercapnic mixture, a hyperoxic mixture and finally a 0.3% CO mixture. The parameters with the fastest response to the sudden change of O2 in inhaled gas were peripheral capillary oxygen saturation (SpO2) and regional tissue oxygenation (rSO2). Transcutaneous oxygen partial pressure (tcpO2) had almost the same time of reaction, but its time of relaxation was 2–3 times longer. End-tidal carbon dioxide (EtCO2) response time to change of CO2 concentration in inhaled gas was less than half in comparison with transcutaneous carbon dioxide partial pressure (tcpCO2). All the examined parameters and devices reacted adequately to changes in gas concentration in the inspiratory gas mixture.

Keywords: near infrared spectroscopy; non-invasive respiratory monitoring; pulse oximetry; transcutaneous monitoring

References

  • [1]

    Barker SJ, Curry J, Redford D, Morgan S. Measurement of carboxyhemoglobin and methemoglobin by pulse oximetry: a human volunteer study. Anesthesiology 2006; 105: 892–897.Google Scholar

  • [2]

    Brugger H, Sumann G, Meister R, et al. Hypoxia and hypercapnia during respiration into an artificial air pocket in snow: implications for avalanche survival. Resuscitation 2003; 58: 81–88.Google Scholar

  • [3]

    Buehler S, Jensen MC, Lozano-Zahonero S, et al. The dynamics of carbon dioxide equilibration after alterations in the respiratory rate. Physiol Meas 2013; 34: 1151–1161.Google Scholar

  • [4]

    Cairo JM, Pilbeam SP. Mechanical ventilation: physiological and clinical applications. 5th ed. St. Louis: Elsevier 2012.Google Scholar

  • [5]

    Casati A, Squicciarini G, Malagutti G, Baciarello M, Putzu M, Fanelli A. Transcutaneous monitoring of partial pressure of carbon dioxide in the elderly patient: a prospective, clinical comparison with end-tidal monitoring. J Clin Anesth 2006; 18: 436–440.Google Scholar

  • [6]

    Cherniack NS, Longobardo GS, Staw I, Heymann M. Dynamics of carbon dioxide stores changes following an alteration in ventilation. J Appl Physiol 1966; 21: 785–793.Google Scholar

  • [7]

    Ehrenfeld JM, Cannesson M, editors. Monitoring technologies in acute care environments: a comprehensive guide to patient monitoring technology. New York: Springer 2014.Google Scholar

  • [8]

    Eichhorn L, Erdfelder F, Kessler F, et al. Evaluation of near-infrared spectroscopy under apnea-dependent hypoxia in humans. J Clin Monit Comput 2015; 29: 749–757.Google Scholar

  • [9]

    Feiner JR, Rollins MD, Sall JW, Eilers H, Au P, Bickler PE. Accuracy of carboxyhemoglobin detection by pulse CO-oximetry during hypoxemia. Anesthesia 2013; 117: 847–858.Google Scholar

  • [10]

    Gehring H, Hornberger C, Matz H, Konecny E, Schmucker P. The effects of motion artifact and low perfusion on the performance of a new generation of pulse oximeters in volunteers undergoing hypoxemia. Resp Care 2002; 47: 48–60.Google Scholar

  • [11]

    Genbrugge C, Dens J, Meex I, et al. Regional cerebral oximetry during cardiopulmonary resuscitation: useful or useless? J Emerg Med 2016; 50: 198–207.Google Scholar

  • [12]

    Goldstein M. Carbon monoxide poisoning. J Emerg Nurs 2008; 34: 538–542.Google Scholar

  • [13]

    Górska K, Korczyński P, Maskey-Warzęchowska M, Chazan R, Krenke R. Variability of transcutaneous oxygen and carbon dioxide pressure measurements associated with sensor location. Adv Exp Med Biol 2015; 858: 39–46.Google Scholar

  • [14]

    Hampson NB. Noninvasive pulse CO-oximetry expedites evaluation and management of patients with carbon monoxide poisoning. Am J Emerg Med 2012; 30: 2021–2024.Google Scholar

  • [15]

    Huttmann SE, Windisch W, Storre JH. Techniques for the measurement and monitoring of carbon dioxide in the blood. Ann Am Thorac Soc 2014; 11: 645–652.Google Scholar

  • [16]

    Kaymak C, Basar H. Carbon monoxide intoxication – Review. Fabad J Pharm Sci 2010; 35: 163–172.Google Scholar

  • [17]

    Kesten S, Chapman KR, Rebuck AS. Response characteristics of a dual transcutaneous oxygen/carbon dioxide monitoring system. Chest 1991; 99: 1211–1215.Google Scholar

  • [18]

    Lermuzeaux M, Meric H, Sauneuf B, et al. Superiority of transcutaneous CO2 over end-tidal CO2 measurement for monitoring respiratory failure in nonintubated patients: a pilot study. J Crit Care 2016; 31: 150–156.Google Scholar

  • [19]

    MacLeod DB, Cortinez LI, Keifer JC, et al. The desaturation response time of finger pulse oximeters during mild hypothermia. Anaesthesia 2005; 60: 65–71.Google Scholar

  • [20]

    Nishiyama T, Nakamura S, Yamashita K. Effects of the electrode temperature of a new monitor, TCM4, on the measurement of transcutaneous oxygen and carbon dioxide tension. J Anesth 2006; 20: 331–334.Google Scholar

  • [21]

    Nishiyama T, Nakamura S, Yamashita K. Comparison of the transcutaneous oxygen and carbon dioxide tension in different electrode locations during general anaesthesia. Eur J Anaesth 2006; 23: 1049–1054.Google Scholar

  • [22]

    Prockop LD, Chichkova RI. Carbon monoxide intoxication: an updated review. J Neurol Sci 2007; 262: 122–130.Google Scholar

  • [23]

    Redford D, Paidy S, Kashif F. Absolute and trend accuracy of a new regional oximeter in healthy volunteers during controlled hypoxia. Anesthesia 2014; 119: 1315–1319.Google Scholar

  • [24]

    Reid CW, Martineau RJ, Miller DR, Hull KA, Baines J, Sullivan PJ. A comparison of transcutaneous, end-tidal and arterial measurements of carbon dioxide during general anaesthesia. Can J Anaesth 1992; 39: 31–36.Google Scholar

  • [25]

    Restrepo RD, Hirst KR, Wittnebel L, Wettstein R. AARC clinical practice guideline: transcutaneous monitoring of carbon dioxide and oxygen: 2012. Resp Care 2012; 57: 1955–1962.Google Scholar

  • [26]

    Rich K. Transcutaneous oxygen measurements: implications for nursing. J Vasc Nurs 2001; 19: 55–59.Google Scholar

  • [27]

    Roth D, Herkner H, Schreiber W, et al. Accuracy of noninvasive multiwave pulse oximetry compared with carboxyhemoglobin from blood gas analysis in unselected emergency department patients. Ann Emerg Med 2011; 58: 74–79.Google Scholar

  • [28]

    Roubik K, Sieger L, Sykora K. Work of breathing into snow in the presence versus absence of an artificial air pocket affects hypoxia and hypercapnia of a victim covered with avalanche snow: a randomized double blind crossover study. PLoS One 2015; 10: e0144332.Google Scholar

  • [29]

    Scheeren TWL, Schober P, Schwarte LA. Monitoring tissue oxygenation be near infrared spectroscopy (NIRS): background and current applications. J Clin Monit Comput 2012; 26: 279–287.Google Scholar

  • [30]

    Sivarajan VB, Bohn D. Monitoring of standard hemodynamic parameters: heart rate, systemic blood pressure, atrial pressure, pulse oximetry, and end-tidal CO2. Pediatr Crit Care Med 2011; 12: S2–11.Google Scholar

  • [31]

    Spelten O, Fiedler F, Schier R, Wetsch WA, Hinkelbein J. Transcutaneous PtcCO2 measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients. J Clin Monit Comput 2017; 31: 153–158.Google Scholar

  • [32]

    Storre JH, Magnet FS, Dreher M, Windisch W. Transcutaneous monitoring as a replacement for arterial PCO2 monitoring during nocturnal non-invasive ventilation. Resp Med 2011; 105: 143–150.Google Scholar

  • [33]

    Tobias JD. Transcutaneous carbon dioxide monitoring in infants and children. Pediatr Anesth 2009; 19: 434–444.Google Scholar

  • [34]

    Trivedi NS, Ghouri AF, Shah NK, Lai E, Barker SJ. Pulse oximeter performance during desaturation and resaturation: a comparison of seven models. J Clin Anesth 1997; 9: 184–188.Google Scholar

  • [35]

    van Oppen JD, Daniel PS, Sovani MP. What is the potential role of transcutaneous carbon dioxide in guiding acute noninvasive ventilation? Resp Care 2015; 60: 484–491.Google Scholar

  • [36]

    Vazquez AL, Fukuda M, Tasker ML, Masamoto K, Kim SG. Changes in cerebral arterial, tissue and venous oxygenation with evoked neural stimulation: implications for hemoglobin-based functional neuroimaging. J Cereb Blood Flow Metab 2010; 30: 428–439.Google Scholar

  • [37]

    Walsh BK, Crotwell DN, Restrepo RD. Capnography/capnometry during mechanical ventilation: 2011. Resp Care 2011; 56: 503–509.Google Scholar

  • [38]

    Yip WL. Evaluation of the clinimetrics of transcutaneous oxygen measurement and its application in wound care. Int Wound J 2015; 12: 625–629.Google Scholar

  • [39]

    Yu M, Morita SY, Daniel SR, Chapital A, Waxman K, Severino R. Transcutaneous pressure of oxygen: a noninvasive and early detector of peripheral shock and outcome. Shock 2006; 26: 450–456.Google Scholar

About the article

Received: 2016-12-18

Accepted: 2017-07-03

Published Online: 2017-08-12

Published in Print: 2018-11-27


Funding: The work was supported by grant SGS17/203/OHK4/3T/17 of the Czech Technical University in Prague and by project reg.no. CZ.2.16/3.1.00/21564 from OP Prague Competitiveness.

Conflict of interest statement: The authors state no conflict of interest.


Citation Information: Biomedical Engineering / Biomedizinische Technik, Volume 63, Issue 6, Pages 647–655, ISSN (Online) 1862-278X, ISSN (Print) 0013-5585, DOI: https://doi.org/10.1515/bmt-2017-0070.

Export Citation

©2018 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Comments (0)

Please log in or register to comment.
Log in