Transcutaneous PC02 & PO2 probe placement

[Skysurfer]

Hello 99ers,

i would be curious to know if you place the heated probe on the babies abdomen or not. If not, why not?

I recently followed a discussion where a nurse argued, that the heated probe can lead to "inflammatory like" processes under the skin surface, because of the generated heat, which in turn can lead to a greater risk for NEC....

I cant imagine the mechanism of this theory and i havent heard of anything like that so far. I wouldn`t stick the probe onto a symptomatic belly, but i haven`t experienced anything in that direction when a probe was stuck onto a asymptomatic belly. I already searched my books and everything i found was always the same: Exclude bony areas such as the spine, the rib cage etc. exclude damaged skin areas, uneven areas and areas that need to be visibly assessed.

Maybe one of you can help me out with that

Cheers Norbert

Edited July 18, 2008 by Skysurfer

[Stefan Johansson]

Hi Norbert!

I have never heard about such an association, sounds like a far-fetched argument to me. I browsed PubMed but I could not find anything there.

Did you get any info about the primary source for this discussion (case report etc)?

[Skysurfer]

Hi Stefan,

our new Head- Nurse just saw a preemie with a probe on his belly and so she went to the nurse in charge to give her the "latest" but anecdotal information, that at the hospital where she formerly worked it was forbidden to put a probe on a childs belly because of the mechanisms mentioned above.

As i said before, i serched the literature myself but wasn`t able to find anything neither supporting, nor invalidating her information.

But thank you for your information.

I talked to our consultant about this and he said, that he hasn`t heard anything like that so far. So we continued to use the bellies again...

Cheers Norbert

[Guest Colette Q]

I have used TC monitoring since the 1980s and have never heard of this contraindication to probe placement.

"the "inflammatory like" processes under the skin surface is an erythema that forms in response to the probe's function. It heats the capillaries underneath to facilatate monitoring of O2 and CO2 levels. This is perfectly normal and it disappears after the site is changed. Tiny prems may need the site changed more frequently if there is a concern regarding skin integrity. Lowering the temperature of the probe can result in less accurate measurements. A tiny 500g infant has little space to site a probe other than the abdomen.

Colette Quinn

[JACK]

... A tiny 500g infant has little space to site a probe other than the abdomen.

Colette Quinn

May be you should check this out

Evaluation of a new combined transcutaneous measurement of PCO2/pulse oximetry oxygen saturation ear sensor in newborn patients.

Pediatrics. 2005 Jan;115(1):e64-8. Epub 2004 Dec 15.

LINK TO THIS FREE ARTICLE

[Guest JoannieO]

Can't help you there - the last time I used a TCM was in the early 90's. We find that we get the same information via pulse oximetry and blood gases. Since our sick babies always get an arterial line, sampling is easy and gives us very accurate results.