集中治療における経皮二酸化炭素分圧と動脈血酸素飽和度同時測定システム（ＴＯＳＣＡ）の使用経験

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  • Utilization of a new combined transcutaneous measurement of PCO2/pulse oximetry oxygen saturation ear sensor in an intensive care unit

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We report the utilization of a new ear sensor (TOSCA(R), Linde, Switzerland) that enable both transcutaneous measurement of arterial carbon dioxide tension and pulse oximetry oxygen saturation in an intensive care unit. The subjects were 12 critically ill patients who were admitted to our intensive care unit. The ear sensor was threaded in the right or left ear lobule for serial measurements of transcutaneous carbon dioxide tension (PtcCO2) and pulse oximetry saturation (SpO2). Arterial carbon dioxide tension (PaCO2) and arterial oxygen saturation (SaO2) were determined by blood gas analysis and were compared with PtcCO2 and SpO2, respectively. A significant relationship was found between PtcCO2 and PaCO2 (correlation coefficiency: 0.95). However, the difference between PtcCO2 and PaCO2 was tended to increase when PaCO2 was more than 50mmHg. Serious complications associated with utilization of the ear sensor did not occur, and inability of measurement caused by position change of patient was not found. The discrepancy between PtcCO2 and PaCO2 increased following norepinephrine administration in a shock case. These results suggested that serial monitoring of PtcCO2 using the ear sensor (TOSCA(R)) might be useful during mechanical ventilation in an intensive care unit. However, further evaluation is needed to confirm precise measurements of PtcCO2 and SpO2 using the ear sensor (TOSCA(R)) when patients are in a hypoperfusion state such as hemorrhagic shock.

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