Transcutaneous partial pressure of carbon dioxide monitoring during EUS-guided drainage of peripancreatic fluid collections using carbon dioxide insufflation: A prospective study

BACKGROUND: Carbon dioxide (CO(2)) insufflation has become more commonly used in EUS-guided interventions in recent years. However, there is a paucity of information regarding methods by which to monitor in vivo CO(2) levels. This study aimed to assess the feasibility of a novel noninvasive method to monitor transcutaneous partial pressure of CO(2) (P(CO(2))) (P(tc(CO(2)))) levels during EUS-guided drainage of peripancreatic fluid collections (PFCs). The safety of CO(2) insufflation in EUS-guided interventions was also investigated. PATIENTS AND METHODS: Patients who underwent EUS-guided PFC drainage between September 2015 and December 2016 at Shengjing Hospital of China Medical University were prospectively enrolled in this study. P(tc(CO(2))) was measured in all patients using a noninvasive sensor throughout the procedure. RESULTS: There were 25 patients eligible to be included in this study. The mean procedure time was 53.1 min. The mean P(tc(CO(2))) level was 40 ± 4 mmHg and 48 ± 5 mmHg before and after the procedure, respectively. The mean peak P(tc(CO(2))) during the procedure was significantly higher at 53 ± 6 mmHg (P < 0.0001). No complications associated with CO(2) insufflation such as CO(2) narcosis, gas embolism, or arrhythmias were encountered. CONCLUSIONS: P(tc(CO(2))) monitoring can accurately reflect the level of P(CO(2)) continuously and noninvasively. CO(2) insufflation is safe for patients undergoing relatively complicated EUS-guided drainage of PFCs.