• Florent Baudin, Pierre Bourgoin, David Brossier, Sandrine Essouri, Guillaume Emeriaud, Marc Wysocki, and Philippe Jouvet.
• 1Pediatric Intensive Care Unit, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada.2Pediatric Intensive Care Unit, Department of Pediatrics, HFME-Hospices Civils de Lyon, Bron, France.3Pediatric Intensive Care Unit, Department of Pediatrics, CHU-Nantes, Nantes, France.4Pediatric Intensive Care Unit, Department of Pediatrics, Hôpitaux Universitaires Paris-Sud AP-HP, Kremlin-Bicêtre, Paris.5Research Center, CHU Sainte-Justine, Montreal, QC, Canada.
• Pediatr Crit Care Me. 2016 Dec 1; 17 (12): 1117-1123.

ObjectivesThe aim of our pilot study was to develop a model to better predict Paco2 in mechanically ventilated children using noninvasive parameters including volumetric capnography.DesignProspective clinical pilot study.SettingLevel III PICU.PatientsSixty-five mechanically ventilated children.InterventionsNone.Materials And MethodsWe conducted a prospective clinical pilot study that included all children admitted to the PICU (< 18 yr; weight, > 3 kg; mechanically ventilated, > 6 hr; with an arterial line). A predictive model for PaCO2 was developed using linear multivariable regression. Among the data collected in PICU patients, candidate predictors of PaCO2 were defined by a panel of experts and included end-tidal partial pressure of carbon dioxide, ventilation parameters, and data resulting from the analysis of volumetric capnogram recorded 5 minutes before an arterial blood gas. Children with tidal volume less than 30 mL were excluded because of technical limits.ResultsA total of 65 children (43 boys, 65%) (65 [21-150] mo old) were analyzed. By linear multivariable regression, the best model included the mean airway pressure, end-tidal partial pressure of carbon dioxide, FIO2, and the capnographic index with an R equal to 0.90, p value less than 0.001. After correction, 95% (n = 62) of children had an estimated PaCO2 at ± 5 mm Hg.ConclusionOur model developed provides an accurate estimation of the PaCO2 using end-tidal CO2 and noninvasive variables. Studies are needed to validate the equation in PICUs.

13 keywords...

hide…