AARC Clinical Practice Guideline: Transcutaneous Monitoring of Carbon Dioxide and Oxygen: 2012

作者：Restrepo Ruben D^*; Hirst Keith R; Wittnebel Leonard; Wettstein Richard

来源：Respiratory Care, 2012, 57(11): 1955-1962.

DOI：10.4187/respcare.02011

• clinical practice guidelines
• hyperbaric oxygen therapy
• reperfusion
• transcutaneous monitoring
• transcutaneous carbon dioxide
• transcutaneous carbon dioxide monitoring
• transcutaneous oxygen
• transcutaneous oxygen monitoring

An electronic literature search for articles published between January 1990 and September 2011 was conducted by using the PubMed, CINAHL, SCOPUS, and Cochrane Library databases. The update of this clinical practice guideline is the result of reviewing a total of 124 articles: 3 randomized controlled trials, 103 prospective trials, 1 retrospective study, 3 case studies, 11 review articles, 2 surveys and 1 consensus paper on transcutaneous monitoring (TCM) for P-tcO2 and P-tcCO2. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria: (1) Although P-tcCO2 has a good correlation with P-aCO2 and is a reliable method to evaluate plasma CO2 levels, it is recommended that arterial blood gas values be compared to transcutaneous readings taken at the time of arterial sampling, in order to verify the transcutaneous values, and periodically as dictated by the patient%26apos;s clinical condition. (2) It is suggested that P-tcCO2 may be used in clinical settings where monitoring the adequacy of ventilation is indicated. (3) It is suggested that P-tcO2 and P-tcCO2 may be used in determining the adequacy of tissue perfusion and monitoring of reperfusion. (4) It is suggested that TCM should be avoided in the presence of increased thickness or edema of the skin and/or subcutaneous tissue where the sensor is applied. (5) It is recommended that sites used for a TCM be changed as often as necessary and that they be alternated and observed to avoid thermal injury. Manufacturer recommendations should be followed.

• 出版日期2012-11