Application of Transcutaneous Carbon Dioxide Tension Monitoring with Low Electrode Temperatures in Premature Infants in the Early Postnatal Period

Abstract

Objective The aim of this article is to evaluate the accuracy, precision, and safety of transcutaneous carbon dioxide tension (TcPCO₂) monitoring at different electrode temperatures in preterm infants in the early postnatal period.

Study Design A total of 26 neonates with a median birth weight of 974 g (432–1,694 g) and gestational age of 28.0 weeks (26.1–31.3 weeks) were studied in the first 5 days of life. A total of 252 simultaneous pairs (TcPCO₂ and arterial carbon dioxide tension [PaCO₂]) were analyzed at 38, 39, and 40°C at 26 and 27 weeks, and at 38, 39, 40, and 42°C at 28 to 31 weeks.

Results The mean difference of TcPCO₂ and PaCO₂ (bias) increased from 3.93 mm Hg at 42°C to 5.64 mm Hg at 40°C, 6.58 mm Hg at 39°C, and 6.07 mm Hg at 38°C. Standard deviation (SD) of the bias increased from 4.17 mm Hg at 42°C to 4.76 mm Hg at 40°C, 5.29 mm Hg at 39°C, and 5.07 mm Hg at 38°C. Adverse skin lesions were not observed.

Conclusion TcPCO₂ measurements are the most accurate and precise at an electrode temperature of 42°C. However, in premature babies, monitoring at 38, 39, and 40°C is possible provided a bias correction of 6 mm Hg and SD of 5 mm Hg are applied.

Keywords

carbon dioxide - electrode temperature - arterial blood sampling - premature infant - newborn

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