TY - JOUR

T1 - Associations between clinical interventions and transcutaneous blood gas values in postoperative patients

AU - Thy, Sandra A.

AU - Johansen, Andreas O.

AU - Thy, André

AU - Sørensen, Henrik H.

AU - Mølgaard, Jesper

AU - Foss, Nicolai B.

AU - Toft, Palle

AU - Meyhoff, Christian S.

AU - Aasvang, Eske K.

N1 - Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer Nature B.V.

PY - 2023

Y1 - 2023

N2 - Purpose: Postoperative monitoring of circulation and respiration is pivotal to guide intervention strategies and ensure patient outcomes. Transcutaneous blood gas monitoring (TCM) may allow for noninvasive assessment of changes in cardiopulmonary function after surgery, including a more direct assessment of local micro-perfusion and metabolism. To form the basis for studies assessing the clinical impact of TCM complication detection and goal-directed-therapy, we examined the association between clinical interventions in the postoperative period and changes in transcutaneous blood gasses. Methods: Two-hundred adult patients who have had major surgery were enrolled prospectively and monitored with transcutaneous blood gas measurements (oxygen (TcPO2) and carbon dioxide (TcPCO2)) for 2 h in the post anaesthesia care unit, with recording of all clinical interventions. The primary outcome was changes in TcPO2, secondarily TcPCO2, from 5 min before a clinical intervention versus 5 min after, analysed with paired t-test. Results: Data from 190 patients with 686 interventions were analysed. During clinical interventions, a mean change in TcPO2 of 0.99 mmHg (95% CI-1.79–0.2, p = 0.015) and TcPCO2 of−0.67 mmHg (95% CI 0.36–0.98, p < 0.001) was detected. Conclusion: Clinical interventions resulted in significant changes in transcutaneous oxygen and carbon dioxide. These findings suggest future studies to assess the clinical value of changes in transcutaneous PO2 and PCO2 in a postoperative setting. Trial registry: Clinical trial number: NCT04735380. Clinical trial registry: https://clinicaltrials.gov/ct2/show/NCT04735380

AB - Purpose: Postoperative monitoring of circulation and respiration is pivotal to guide intervention strategies and ensure patient outcomes. Transcutaneous blood gas monitoring (TCM) may allow for noninvasive assessment of changes in cardiopulmonary function after surgery, including a more direct assessment of local micro-perfusion and metabolism. To form the basis for studies assessing the clinical impact of TCM complication detection and goal-directed-therapy, we examined the association between clinical interventions in the postoperative period and changes in transcutaneous blood gasses. Methods: Two-hundred adult patients who have had major surgery were enrolled prospectively and monitored with transcutaneous blood gas measurements (oxygen (TcPO2) and carbon dioxide (TcPCO2)) for 2 h in the post anaesthesia care unit, with recording of all clinical interventions. The primary outcome was changes in TcPO2, secondarily TcPCO2, from 5 min before a clinical intervention versus 5 min after, analysed with paired t-test. Results: Data from 190 patients with 686 interventions were analysed. During clinical interventions, a mean change in TcPO2 of 0.99 mmHg (95% CI-1.79–0.2, p = 0.015) and TcPCO2 of−0.67 mmHg (95% CI 0.36–0.98, p < 0.001) was detected. Conclusion: Clinical interventions resulted in significant changes in transcutaneous oxygen and carbon dioxide. These findings suggest future studies to assess the clinical value of changes in transcutaneous PO2 and PCO2 in a postoperative setting. Trial registry: Clinical trial number: NCT04735380. Clinical trial registry: https://clinicaltrials.gov/ct2/show/NCT04735380

KW - Post anesthesia care unit

KW - Postsurgical monitoring

KW - Transcutaneous blood gas monitoring

U2 - 10.1007/s10877-023-00982-x

DO - 10.1007/s10877-023-00982-x

M3 - Journal article

C2 - 36808596

AN - SCOPUS:85148345051

VL - 37

SP - 1255

EP - 1264

JO - Journal of Clinical Monitoring and Computing

JF - Journal of Clinical Monitoring and Computing

SN - 1387-1307

ER -