Advantages of transcutaneous CO2 over end tidal CO2 for sleep monitoring

August 6, 2014

Presented by Prof. Ramalinga Reddy, MD, Clinical Professor of Pediatrics, University of Toledo College of Medicine

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The Advantages of Transcutaneous CO2 Over End-Tidal CO2 for Sleep Monitoring: Session 1
Presenter: Ramalinga Reddy, MD, MBA
Medical Director, Pediatric Pulmonary and Sleep Center, Mercy Children's Hospital, Toledo, OH
Clinical Professor of Pediatrics, University of Toledo, Medical Science Campus, Toledo, OH

Sleep-related breathing disorders are common and often associated with hypoxemia and/or hypercapnia. Evaluation of a patient’s respiratory and ventilatory status is often based on intermittent arterial samples that are neither practical during sleep nor offer continuous blood gas monitoring. End-tidal CO2 (ETCO2) monitoring is used to indicate patient ventilation status as it reflects trends of arterial pCO2 (PaCO2).

The accuracy of this technique depends on sampling undiluted alveolar gas during expiration, but factors like tachypnea or increased physiologic dead space may result in an underestimation of the PaCO2. Severe airway obstruction, mouth breathing or limitation of expiratory flow, etc. may also influence the ETCO2 accuracy.

Transcutaneous carbon dioxide monitoring (tcpCO2) shows trends of PaCO2. The technique is widely used during and after non-invasive ventilation (NIV) and during sleep on adults as well as on neonatal and pediatric patients.

Several studies document that patients with respiratory diseases involving shunts or V/Q mismatches are more accurately monitored by tcpCO2 than by ETCO2. This webinar will summarize the CO2 measurement landscape and distinguish between the various methods currently in the sleep lab, and compare the detection accuracy and trend prediction capabilities of transcutaneous CO2 vs. the end-tidal method.

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