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  • Title: Clinical use of continuous arterial blood gas monitoring in the pediatric intensive care unit.
    Author: Weiss IK, Fink S, Harrison R, Feldman JD, Brill JE.
    Journal: Pediatrics; 1999 Feb; 103(2):440-5. PubMed ID: 9925838.
    Abstract:
    CONTEXT: Continuous arterial blood gas monitoring is a new technology based on the combination of opto-chemical and fiber-optic detectors that can measure pH, PCO2, PO2, and temperature on a continuous basis via a sensor placed in an artery. OBJECTIVE: To evaluate this technology in pediatric patients who would normally require frequent arterial blood gas sampling. DESIGN: A criterion standard study in which the results of arterial blood gas samples measured by the laboratory analyzer were compared with the sensor readings. SETTING: A pediatric intensive care unit of a tertiary referral center. PATIENTS: Children with severe respiratory failure who required frequent arterial blood gas sampling and who had a 20-gauge arterial line in either a radial or femoral site. RESULTS: Twenty-four patients with a mean age of 6.4 years (range 1-21 years) had a sensor placed. Sensors were in place for a mean of 101 +/- 62 hours. Eighteen patients underwent continuous monitoring for at least 24 hours or until no longer clinically necessary. There were 414 pairs of blood gas samples obtained. The bias/precision for pH was 0.005/0.030; for PCO2, -1.8/6.3 mm Hg; and for PO2, 1.2/24 mm Hg. The correlation (r value) between the sensor readings and the blood gases were pH 0. 960, PCO2 0.927, PO2 0.813 (P <.01 for all values). The bias and precision for PO2 levels < 70 mm Hg were 0.057/9.34 mm Hg. There were no complications from sensor placement. Continuous blood gas monitoring allowed immediate recognition of clinical changes. CONCLUSION: The continuous arterial blood gas sensor is capable of clinically accurate blood gas measurements. This technology provides the clinician with immediate data that can allow rapid interventions in unstable patients.
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