• Anesthesia and analgesia · Jun 2001

    Comparative Study Clinical Trial

    Noninvasive monitoring of carbon dioxide during mechanical ventilation in older children: end-tidal versus transcutaneous techniques.

    • J W Berkenbosch, J Lam, R S Burd, and J D Tobias.
    • Department of Child Health, Division of Pediatric Critical Care/Pediatric Anesthesiology, University of Missouri, Columbia, 65212, USA. berkenboschj@health.missouri.edu
    • Anesth. Analg. 2001 Jun 1;92(6):1427-31.

    UnlabelledWe prospectively compared the accuracy of end-tidal CO(2) (ETCO(2)) and transcutaneous CO(2) (TCCO(2)) monitoring in older pediatric patients (4 yr or older) receiving mechanical ventilation for respiratory failure. ETCO(2) and TCCO(2) were simultaneously monitored and compared with arterial CO(2) (PaCO(2)) values when arterial blood gas analysis was performed. Eighty-two sample sets were compared. The ETCO(2) to PaCO(2) difference was 6.4 +/- 6.3 mm Hg, whereas the TCCO(2) to PaCO(2) difference was 2.6 +/- 2.0 mm Hg (P < 0.0001). The absolute difference of ETCO(2) and PaCO(2) was 5 or less in 47 of 82 measurements, whereas the absolute TCCO(2) to PaCO(2) difference was 5 or less in 76 of 82 measurements (P < 0.00001). Regression analysis of ETCO(2) and PaCO(2) values revealed a correlation coefficient of 0.5418 and an r value of 0.8745. Regression analysis of TCCO(2) and PaCO(2) values revealed a correlation coefficient of 1.0160 and an r value of 0.9693. Bland-Altman analysis revealed a bias of -5.68 with a precision of +/-6.93 when comparing ETCO(2) with PaCO(2) and a bias of 0.02 with a precision of +/-3.27 when comparing TCCO(2) and PaCO(2) (P < 0.00001). TCCO(2) monitoring provided an accurate estimation of PaCO(2) over a wide range of CO(2) values and was superior to ETCO(2) monitoring in older pediatric patients with respiratory failure. TCCO(2) monitoring may be considered as a useful adjunct to monitoring of ventilation in this patient population.ImplicationsThe authors report on the accuracy of noninvasive, transcutaneous CO(2) monitoring during mechanical ventilation in children 4 yr or older. Application of this technique should be useful by decreasing the need for repeated, costly, and sometimes painful arterial blood gas analysis, and the continuity of assessment should facilitate proactive, rather than reactive, ventilator manipulations.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…