Evidence map›Paper›PMID 37262066›Full record

Trial reportPloS one2023

Limitations of transcutaneous carbon dioxide monitoring in apneic oxygenation.

Thilo Schweizer, Volker Hartwich, Thomas Riva, Heiko Kaiser, Lorenz Theiler, Robert Greif, Sabine Nabecker

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03478774 (Physiology Regarding Apnoeic Oxygenation During Nasal Cannula Therapy at Different Flow Rates), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03478774 nacompletednot on this map

Physiology Regarding Apnoeic Oxygenation During Nasal Cannula Therapy at Different Flow Rates

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2018 to 2019Enrolled125ConditionsApnoeic OxygenationArmsOxygen 70l/min, Oxygen 10 l/min, Oxygen 2l/min, Jaw thrust, Videolaryngoscopy
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. High-flow nasal oxygen in anesthesiology practice.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026
    Review
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Thilo SchweizerDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Volker HartwichIndependent Researcher, Bern, Switzerland.
Thomas RivaDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0003-1297-3427
Heiko KaiserDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0002-6082-9510
Lorenz TheilerDepartment of Anesthesiology, Cantonal Hospital Aarau, Aarau, Switzerland.
Robert GreifDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0003-0160-2073
Sabine NabeckerDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0001-9524-0821

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-flow nasal oxygenation is increasingly used during sedation procedures and general anesthesia in apneic patients. Transcutaneous CO2 (ptcCO2)-monitoring is used to monitor hypercapnia. This study investigated ptcCO2-monitoring during apneic oxygenation.

methodsWe included 100 patients scheduled for elective surgery under general anesthesia in this secondary analysis of a randomized controlled trial. Before surgery, we collected ptcCO2 measured by TCM4 and TCM5 monitors and arterial blood gas (ABG) measurements every two minutes during 15 minutes of apnea. Bland-Altman plots analyzed agreement between measurement slopes; linear mixed models estimated the different measuring method effect, and outlined differences in slope and offset between transcutaneous and arterial CO2 partial pressures.

resultsBland-Altman plots showed a bias in slope (95% confidence intervals) between ABG and TCM4-measurements of 0.05mmHg/min (-0.05 to 0.15), and limits of agreement were -0.88mmHg/min (-1.06 to -0.70) and 0.98mmHg/min (0.81 to 1.16). Bias between ABG and TCM5 was -0.14mmHg/min (-0.23 to -0.04), and limits of agreement were -0.98mmHg/min (-1.14 to -0.83) and 0.71mmHg/min (0.55 to 0.87). A linear mixed model (predicting the CO2-values) showed an offset between arterial and transcutaneous measurements of TCM4 (-15.2mmHg, 95%CI: -16.3 to -14.2) and TCM5 (-19.1mmHg, -20.1 to -18.0). Differences between the two transcutaneous measurements were statistically significant.

conclusionsSubstantial differences were found between the two transcutaneous measurement systems, and between them and ABG. Transcutaneous CO2 monitoring cannot replace arterial CO2-monitoring during apneic oxygenation. In clinical settings with rapidly changing CO2-values, arterial blood gas measurements are needed to reliably assess the CO2-partial pressure in blood.

trial registrationClinicalTrials.gov (NCT03478774).

Indexed as

Blood Gas Monitoring, TranscutaneousCarbon DioxideAnesthesia, GeneralHumansHypercapniaRespiration, ArtificialCarbon Dioxide

Identifiers

PMID37262066
PMCPMC10234524

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.