Transcutaneous pO₂ Monitoring in PICU

Detailed Description

Arterial blood gas (ABG) analysis is the gold standard for assessing oxygenation and ventilation in critically ill children admitted to the pediatric intensive care unit (PICU). Despite its clinical value, ABG sampling is invasive, may cause discomfort, and often requires repeated blood draws. Transcutaneous monitoring offers a noninvasive, continuous method for estimating partial pressures of oxygen (pO₂) and carbon dioxide (pCO₂) through the skin. However, the accuracy and clinical reliability of transcutaneous measurements in critically ill pediatric patients remain variable and require further evaluation.

This observational cohort study aims to assess the agreement between transcutaneous pO₂ (Tc pO₂) and pCO₂ (Tc pCO₂) measurements and corresponding arterial blood gas values (PaO₂ and PaCO₂) in pediatric patients admitted to the PICU. Eligible patients are those who undergo arterial blood gas sampling and concurrent transcutaneous monitoring as part of routine clinical care. Paired measurements will be obtained simultaneously to minimize temporal variability and ensure comparability.

The primary outcome of the study is the agreement between Tc pO₂ and PaO₂ measurements. Secondary analyses will evaluate the agreement between Tc pCO₂ and PaCO₂ values. Agreement will be assessed using appropriate statistical methods, including correlation analysis and Bland-Altman analysis, to determine bias and limits of agreement between measurement techniques.

By evaluating the performance of transcutaneous monitoring in a real-world PICU setting, this study seeks to determine whether Tc pO₂ can be considered a reliable alternative to arterial oxygen measurements in selected pediatric patients. The findings may support the integration of noninvasive monitoring strategies into clinical practice and potentially reduce the frequency of invasive arterial blood sampling in pediatric intensive care.

Eligibility Criteria

Inclusion criteria

• Age between 1 month and 18 years
• Admission to the Pediatric Intensive Care Unit (PICU)
• Presence of an arterial catheter allowing arterial blood gas (ABG) sampling
• Simultaneous or paired transcutaneous pCO₂ and pO₂ monitoring available
• Hemodynamically stable at the time of measurement

Exclusion criteria

• Severe skin disease, burns, or local skin infection at the transcutaneous sensor site
• Severe peripheral perfusion impairment (e.g., refractory shock or high-dose vasopressor support)
• Congenital or acquired conditions interfering with accurate transcutaneous measurements
• Technical failure or inability to obtain reliable transcutaneous readings
• Missing or incomplete paired ABG-transcutaneous measurement data