Non-invasive (transcutaneous) monitoring of PCO2 (TcPCO2) in older adults.

Background: Transcutaneous measurements of arterial blood gases (ABG) may decrease the need for repeated arterial puncture in older patients treated for acute cardiac or pulmonary disorders. However, age-related changes in skin perfusion, metabolism, or thickness may alter the validity of the technique.

Objective: To analyse the agreement between transcutaneous and arterial measurement of PaO2 and PaCO2 in older adults.

Is continuous transcutaneous monitoring of PCO2 (TcPCO2) over 8 h reliable in adults?

Monitoring of non-invasive ventilation (NIV) in a non-intensive care unit (non-ICU) setting requires a method of evaluating nocturnal PaCO2, such as transcutaneous CO2 monitoring (TcPCO2). However, changing the probe site after 4 h and recalibrating (as recommended) is time-consuming and impractical. Continuous (8-h) TcPCO2 monitoring at a lower electrode temperature (43 degrees C) in this setting has never been formally studied.

Management of dyspnea in severe chronic obstructive pulmonary disease.

Progression of chronic obstructive pulmonary disease (COPD) is frequently associated with increasing dyspnea; indeed, patients with severe COPD constitute the largest group of patients with chronic respiratory insufficiency. The sensation of dyspnea in these patients is mostly related to increased work of breathing, a consequence of an increased resistive load, of hyperinflation, and of the deleterious effect of intrinsic positive end-expiratory pressure (PEEP(i)). Once optimal medical treatment has been provided, pharmacological treatments of dyspnea exist (beta2-agonists, methylxanthines, opiates) but seldom suffice.