Advanced home hospital transcutaneous CO2 monitoring of long-term mechanically ventilated patients

Abstract

Background: Due to limited health care resources and an increasing number of patients established on long term mechanical ventilation (LTMV), a change from the traditional follow up in the hospital to a “hospital at home” approach has been implemented at the Department of Pulmonary Medicine at Oslo University Hospital since 2019.

Technical innovations now allow for the sleep studies to be conducted in the patient`s home. This follow-up from the specialized health care team includes continuous transcutaneous measurement of CO2 (TcCO2) performed during sleep.

Method: 61 patients participated in the project “Hospital at home for patients with LTMV” from January 2021 until August 2022. Patients underwent a continuous measurement of TcCO2 (TCM5, Radiometer) while sleeping at home.

Aim: To re-evaluate whether the use of nocturnal transcutaneous carbon dioxide (TcCO2) measurements at home in patients with long term mechanical ventilation (LTMV) has been technically successful and maintained a success rate of 90%.

Results and conclusion: We performed 133 measurements of TcCO2 where 121 (90%) were judged as of sufficient technical quality. The results show that the use of TcCO2 can be effectively used in the home setting for the monitoring of this patient population.

There are currently 168 patients in Oslo with treatment and follow-up of LTMV, with control at the hospital often every 3-6 months. TcCO2 measurement is performed routinely on all patients.

These results show that the technical quality measurements take at home can be maintained despite scaling up to a larger hospital at home population.