Arterial blood gases during exercise: Validity of transcutaneous measurements Carole Planès, MD, PhD, Michel Leroy, MD, Evelyne Foray, IDE, Bernadette.

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Presentation transcript:

Arterial blood gases during exercise: Validity of transcutaneous measurements Carole Planès, MD, PhD, Michel Leroy, MD, Evelyne Foray, IDE, Bernadette Raffestin, MD, PhD Archives of Physical Medicine and Rehabilitation Volume 82, Issue 12, Pages 1686-1691 (December 2001) DOI: 10.1053/apmr.2001.26248 Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 1 Differences between blood gas tensions measured transcutaneously and by arterial blood sampling (A) oxygen and (B) carbon dioxide at symptom-limited exercise vs average of pressures obtained with the 2 methods. No systematic difference existed between TcPO2E and PaO2E, but TcPCO2E significantly overestimated PaCO2E (p < .001, paired t test). Legend: ..., standard deviation; −, mean. Archives of Physical Medicine and Rehabilitation 2001 82, 1686-1691DOI: (10.1053/apmr.2001.26248) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 2 Magnitudes of O2 change from rest sitting to symptom-limited exercise, (ΔTcPO2E-R vs ΔPaO2E-R). Because resting values were subtracted from values obtained at exercise, values of patients with a decrease in both PaO2 and TcPO2 at exercise are negative and therefore in the left lower quadrant. Legend: −, identity line; ..., regression line. Archives of Physical Medicine and Rehabilitation 2001 82, 1686-1691DOI: (10.1053/apmr.2001.26248) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 3 Differences between the amplitudes of exercise-induced changes in PO2 values obtained transcutaneously and by blood sampling (ΔTcPO2E-R − ΔPaO2E-R) versus average of changes with the 2 methods. Only values of patients with a decrease in both TcPO2E and PaO2E are presented. For clarity, PO2 values during exercise were here subtracted from those at rest (PO2E-R). This approach yielded positive values. Underestimation of changes in arterial PO2 by transcutaneous measures was statistically significant (p < .05, paired t test). Legend: ..., standard deviation; −, mean. Archives of Physical Medicine and Rehabilitation 2001 82, 1686-1691DOI: (10.1053/apmr.2001.26248) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 4 Typical example of O2 tensions at rest and with symptom-limited exercise in a 68-year-old man with interstitial lung disease who underwent repeated exercise tests over 2 years to follow response to steroid treatment. Oxygen tensions measured at rest in the arterial blood (PaO2R) at symptom-limited peak exercise by the transcutaneous probe (TcPO2E) and arterial blood analysis (PaO2E) are given for each of 7 successive tests. Archives of Physical Medicine and Rehabilitation 2001 82, 1686-1691DOI: (10.1053/apmr.2001.26248) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 5 Magnitudes of CO2 change from rest sitting to symptom-limited exercise (ΔTcPCO2E-R vs ΔPaCO2E-R). Because resting values were subtracted from values obtained at exercise, values of patients with an increase in both PaCO2 and TcPCO2 at exercise are positive and therefore in the right upper quadrant. Legend: ..., regression line; −, identity line. Archives of Physical Medicine and Rehabilitation 2001 82, 1686-1691DOI: (10.1053/apmr.2001.26248) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 6 Differences in the magnitudes of exercise-induced change in PCO2 values obtained transcutaneously and by blood sampling (ΔTcPO2E-R − ΔPaO2E-R) versus average of changes with the 2 methods. Only values of patients with an exercise-induced increase in both TcPCO2 and PaCO2 are presented. No systematic significant difference existed between the measurement methods (paired t test). Legend: ..., standard deviation; −, mean. Archives of Physical Medicine and Rehabilitation 2001 82, 1686-1691DOI: (10.1053/apmr.2001.26248) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions