Respiratory medicine · 2026
Impact of home transcutaneous capnography on the assessment of patients with nocturnal hypoxemia.
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Mañana Valdés Claudia, Fernandez Alvarez Ramon, Abad Chamorro Laura, Rodríguez Menéndez Patricia, Ruiz Alvarez Ines, Fernandez Suarez Irene, Vazquez Lopez Maria Jose, Lozano Cuesta Pablo, Guerassimova Ina, López-Arranz Monge Guillermo, Madrid Carbajal Claudia, Rubinos Cuadrado Gemma
Аннотация
BACKGROUND: Sleep studies sometimes identify varying levels of hypoxemia through pulse oximetry; however, this does not distinguish between isolated hypoxemia and coexisting hypoventilation with hypercapnia. Transcutaneous capnography (TcCO2) correlates well with blood gas analysis and would be useful in these cases; however, there is limited information on its use at home in normocapnic patients with nocturnal hypoxemia. Our goal was to assess the impact of adding nocturnal TcCO2 measurement in this group of patients and to compare the measurement differences across different devices used.
METHODS: A cross-sectional design was used to study normocapnic subjects with nocturnal hypoxemia detected during a sleep study. Home transcutaneous capnography and simultaneous pulse oximetry were performed. The study analyzed the detection of nocturnal hypoventilation, potential measurement differences between devices, and the impact on treatment decisions.
RESULTS: Sixty-three subjects (64 ± 13 years; 54 % women) were included. Capnography was abnormal in 30 cases (48 %): 20 (32 %) with hypercapnia and 10 (16 %) with isolated hypoxemia. Specific treatment was recommended for 25 of the cases (83 %): 13 with CPAP and 12 with noninvasive ventilation. Differences between devices were observed in oxygenation data, as capnography measurements did not show hypoxemia in 52 % of the included cases.
CONCLUSIONS: Nocturnal TcCO2 monitoring at home can identify hypoventilation in patients without daytime hypercapnia and help guide suitable therapies. The differences in measurements compared to traditional pulse oximetry require further investigation.
METHODS: A cross-sectional design was used to study normocapnic subjects with nocturnal hypoxemia detected during a sleep study. Home transcutaneous capnography and simultaneous pulse oximetry were performed. The study analyzed the detection of nocturnal hypoventilation, potential measurement differences between devices, and the impact on treatment decisions.
RESULTS: Sixty-three subjects (64 ± 13 years; 54 % women) were included. Capnography was abnormal in 30 cases (48 %): 20 (32 %) with hypercapnia and 10 (16 %) with isolated hypoxemia. Specific treatment was recommended for 25 of the cases (83 %): 13 with CPAP and 12 with noninvasive ventilation. Differences between devices were observed in oxygenation data, as capnography measurements did not show hypoxemia in 52 % of the included cases.
CONCLUSIONS: Nocturnal TcCO2 monitoring at home can identify hypoventilation in patients without daytime hypercapnia and help guide suitable therapies. The differences in measurements compared to traditional pulse oximetry require further investigation.