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Advantages of transcutaneous CO₂ over end tidal CO₂ for sleep monitoring

August 5, 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.