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Related Experiment Videos

Catheter deadspace: a source of error during tonometry

P J Steverink1, J J Kolkman, A B Groeneveld

  • 1Department of General and Large Animal Surgery, Faculty of Veterinary Medicine, University of Utrecht, The Netherlands.

British Journal of Anaesthesia
|June 12, 1998
PubMed
Summary

Tonometry of PCO2, a method for assessing gastrointestinal oxygenation in critically ill patients, can be inaccurate due to catheter deadspace errors. Rinsing the tonometer before each measurement cycle ensures accurate PCO2 readings, even with short dwell times.

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Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Medical Device Engineering

Background:

  • Tonometry of PCO2 is a method to assess gastrointestinal mucosal oxygenation.
  • This technique is underutilized due to methodological issues.
  • Catheter deadspace has been identified as a potential source of error.

Purpose of the Study:

  • To evaluate the impact of catheter deadspace on PCO2 tonometry accuracy.
  • To determine if rinsing the tonometer between measurements can mitigate deadspace errors.
  • To assess the influence of tonometer length on PCO2 measurement accuracy.

Main Methods:

  • PCO2 measurements were taken using normal (NT) and extended (ET) length sigmoid tonometers in saline baths.
  • Saline dwell times ranged from 10 to 90 minutes.

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  • Experiments were conducted with and without rinsing the tonometer between measurement cycles to assess deadspace contamination.
  • PCO2 was measured using a blood-gas analyzer, accounting for saline bias.

    • Main Results:

    • Failure to rinse the tonometer led to PCO2 overestimation, particularly with shorter dwell times and the extended tonometer.
    • Overestimations ranged from 5-31% depending on tonometer type, dwell time, and deadspace PCO2.
    • Rinsing the tonometer between cycles resulted in accurate PCO2 assessment at all dwell times.

    Conclusions:

    • Catheter deadspace is a significant source of error in PCO2 tonometry, especially at short dwell times.
    • Rinsing the tonometer before each measurement is crucial for accurate PCO2 assessment.
    • This simple procedural modification can enhance the clinical applicability of PCO2 tonometry in critically ill patients.