Determination of reference ranges for transcutaneous oxygen and carbon dioxide tension and the oxygen challenge test in healthy and morbidly obese subjects.
BACKGROUND
Transcutaneous monitoring of oxygen and carbon dioxide tension emerged decades ago as reliable, indirect measurements of arterial pressure of oxygen and carbon dioxide in neonates. Investigators have since found other valuable roles for this modality, particularly in critically ill adults. This investigation was undertaken to further characterize these measurements in normal and in obese adults, who are contributing to a rising proportion of intensive care unit admissions.


METHODS
Transcutaneous sensors were adjusted for barometric pressure and calibrated to reference gases. The following were measured: equilibration time; oxygen saturation; transcutaneous oxygen tension; and transcutaneous carbon dioxide tension on room air and after administering fraction of inspired oxygen of 1.0 for 5 min (Oxygen Challenge Test).


RESULTS
One hundred three healthy and 47 obese subjects were enrolled. Oxygen Challenge Test values were 131.5 +/- 57.4 and 171.6 +/- 65.9 mm Hg for obese and healthy subjects, respectively (P value <0.001). Smoking status, respiratory rate, and transcutaneous oxygen tension on room air best predicted the Oxygen Challenge Test response. A negative correlation was found between transcutaneous oxygen on room air and the Oxygen Challenge Test versus body mass index (P < 0.001).


CONCLUSIONS
Reference ranges were determined for transcutaneous oxygen and carbon dioxide tension and the Oxygen Challenge Test in obese and in normal, healthy subjects. Increasing body mass index was associated with a lower baseline transcutaneous oxygen tension, but it was not an independent predictor of the Oxygen Challenge Test response in multivariate analysis.
Nishiguchi
Brian K
BK
Department of Surgery and Division of Surgical Critical Care, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii 96813, USA.
Yu
Mihae
M
Suetsugu
Anthony
A
Jiang
Caroline
C
Takiguchi
Sharon A
SA
Takanishi
Danny M
DM
D000328:Adult; D001785:Blood Gas Monitoring, Transcutaneous; D002245:Carbon Dioxide / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology*; D010100:Oxygen / Q000502:physiology*; D011446:Prospective Studies; D012016:Reference Values
D002245:Carbon Dioxide; D010100:Oxygen