Transcutaneous P _{CO ₂} Measurements With Long-Term Noninvasive Ventilation

<b>Background:</b> Current guidelines recommend that monitoring of long-term noninvasive ventilation (Long-term NIV) should include measurement of nocturnal transcutaneous P_CO₂ (P_tcCO₂). This has previously required an elective hospital admission. However, owing to a growing patient population and advancements in monitoring technology, there is a general trend toward moving specialized health care from the hospital to the home. The aim of this study was to compare the success rate and causes of failure of P_tcCO₂ monitoring at home versus at the hospital and to discuss the criteria used for the evaluation of nocturnal P_tcCO₂ monitoring. <b>Methods:</b> In this real-world observational study, subjects scheduled for long-term NIV follow-up at Oslo University Hospital in the time period January 2020 to December 2022 were prospectively identified. A total of 128 subjects were included, and monitoring occurred either at home or at the hospital. Two physicians, blinded to the location of the monitoring, retrospectively classified the P_tcCO₂ as successful or unsuccessful and identified the causes of failure for the latter. The evaluation was performed using a predefined set of criteria, and results were divided into successful and unsuccessful recordings based on nontechnical (human) errors, time requirements, and technical errors such as fixed bias, instrumental drift, and artifacts. <b>Results:</b> A total of 465 recordings of 128 subjects were performed. A 90% success rate was achieved for both groups. The predominant cause of failure in the home group was nontechnical (50% of total failures), whereas the predominant failure in the hospital group was caused by the recordings not meeting the minimum time requirement (38% of total failures). <b>Conclusions:</b> There was a 90% success rate for P_tcCO₂ measurements both at home and at the hospital. Our findings suggest that P_tcCO₂ measurements can successfully be implemented in the regular follow-up of long-term NIV treatment in a home setting.