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Continuous arterial blood gas monitoring during bilateral sequential lung transplantation
P S Myles1, M R Buckland, A M Weeks
1Department of Anaesthesia and Pain Management, Alfred Hospital, Melbourne, Australia.
Objective:
To determine the accuracy and clinical utility of a continuous arterial blood gas (ABG) monitor during lung transplantation.
Design:
Prospective, observational cohort study.
Setting:
University hospital.
Participants:
Eleven patients undergoing bilateral sequential lung transplantation (BSLTx).
Interventions:
Repeated ABG sampling.
Measurements And Main Results:
Agreement was measured by the bias (limits of agreement): pH, 0.006 (-0.10 to 0.10); PaO2, -22 mmHg (-130 to 86 mmHg); and PaCO2, -1.6 mmHg (-13.4 to 10.2 mmHg). Sensitivity and specificity of the Paratrend 7 (Biomedical Sensors, Ltd, Malvern, PA) PaO2 measurements (to detect PaO2 < 100 mmHg) were 84.6% and 97.6%, respectively.
Conclusion:
Continuous ABG monitoring with the Paratrend 7 shows sufficiently good agreement with laboratory blood gas analysis during BSLTx and thus is a convenient alternative to intermittent laboratory blood gas measurement. Because of the potential for significant (and sometimes rapid) acid-base disturbances, continuous ABG monitoring may have a role during most lung transplantation procedures.