Effect of Transcutaneous Electrode Temperature on Accuracy and Precision of Carbon Dioxide and Oxygen Measurements in the Preterm Infants

BACKGROUND: High electrode temperature during transcutaneous monitoring is associated with skin burns in extremely premature infants. We evaluated the accuracy and precision of CO 2 and O 2 measurements using lower transcutaneous electrode temperatures below 42°C. METHODS: We enrolled 20 neonates. Two transcutaneous monitors were placed simultaneously on each neonate, with one electrode maintained at 42°C and the other randomized to temperatures of 38, 39, 40, 41, and 42°C. Arterial blood was collected twice at each temperature. RESULTS: At the time of arterial blood sampling, values for transcutaneously measured partial pressure of CO 2 (P tcCO 2 ) were not significantly different among test temperatures. There was no evidence of skin burning at any temperature. For P tcCO 2 , Bland-Altman analyses of all test temperatures versus 42°C showed good precision and low bias. Transcutaneously measured partial pressure of O 2 (P tcO 2 ) values trended arterial values but had large negative bias. CONCLUSION: Transcutaneous electrode temperatures as low as 38°C allow an assessment of P tcCO 2 as accurate as that with electrodes at 42°C.