Clinical use of continuous arterial blood gas monitoring in the pediatric intensive care unit

Context. Continuous arterial blood gas monitoring is a new technology based on We combination of opto-chemical and fiber-optic detectors that can meas ure pH, PCO2, PO2, and temperature on a continuous basis via a sensor place d in an artery. Objective. To evaluate this technology in pediatric patients who would norm ally require frequent arterial blood gas sampling. Design. A criterion standard study in which the results of arterial blood g as samples measured by the laboratory analyzer were compared with the senso r readings. Setting. A pediatric intensive care unit of a tertiary referral center. Patients. Children with severe respiratory failure who required frequent ar terial 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 year s) had a sensor placed. Sensors were in place for a mean of 101 +/- 62 hour s. 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 th e 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. C ontinuous blood gas monitoring allowed immediate recognition of clinical ch anges. Conclusion. The continuous arterial blood gas sensor is capable of clinical ly accurate blood gas measurements. This technology provides the clinician with immediate data that can allow rapid interventions in unstable patients .