An in vitro validation of a commercially available metabolic cart using pediatric ventilator volumes

Webster, Patricia A.; King, Sandra E.; Torres, Adalberto

doi:10.1002/(sici)1099-0496(199812)26:6<405::aid-ppul5>3.0.co;2-r

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…The gas exchange method derives VO 2 and VCO 2 from the difference in absolute amounts of oxygen and CO 2 in inspired and exhaled gas using standard formulas (12). The metabolic cart has been validated in the pediatric patient (13,14) and in neonates (15).…”

Section: Methodssupporting

confidence: 61%

Effect of red blood cell transfusion on oxygen consumption in the anemic pediatric patient

Grant

Huether²,

Witte³

2003

Pediatric Critical Care Medicine

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A significant increase in Vo(2) was noted after a red blood cell transfusion in pediatric patients with isovolemic anemia. These findings suggest that Vo(2) was dependent on the supply of oxygen in this subset of pediatric patients. Responding to increased oxygen delivery by increasing Vo(2) implies that these patients were functioning in a state of relative oxygen deficit and had made physiologic adaptive changes to function in this state.

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Section: Methodssupporting

confidence: 61%

Effect of red blood cell transfusion on oxygen consumption in the anemic pediatric patient

Grant

Huether²,

Witte³

2003

Pediatric Critical Care Medicine

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“…First, the size of the airway is smaller, around 4 mm of diameter and any minimum edema may cause severe obstructive symptoms 7 . Moreover, the trachea has less cartilaginous tissue than in adults, generating greater airway instability, increasing respiratory effort and, consequently, higher oxygen consumption 8 . Therefore, our group modified the technique by Tsang and Grillo 3,4 and placed a silicone Y tracheobronchial stent in a few selected patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment of tracheal stenosis with extracorporeal membrane oxygenation support in infants and newborns

et al. 2021

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Tracheal stenosis in children is a challenge for the healthcare team, since it is a rare disease. Patients usually have other clinical comorbidities, mainly previous cardiac surgical interventions. This retrospective single‐center study included infants with tracheal stenosis (congenital or acquired) operated between 2016 and 2020 on venoarterial extracorporeal membrane oxygenation (VA ECMO). Five patients were operated and the median age of detection of the tracheal disease was 3.7 months, and the median age at the operation was 5 months. All patients had associated cardiac anomalies. Four patients had congenital tracheal stenosis; two with associated pig bronchus. One patient had acquired subglottic stenosis with concomitant stenosis at the carina. After the operation, the patients were referred to ICU on ECMO with an open chest. Minor ECMO‐related complications occurred in two patients (hemothorax and wound infection). All patients required endoscopic evaluation during the postoperative care; median of 3.2 procedures. Two patients are currently in follow‐up and three have died. Slide tracheoplasty with VA‐ECMO can be successfully performed in infants with prior cardiac surgery. Nevertheless, a difficult postoperative course should be anticipated, with possible prolonged ECMO use, readmissions, and higher morbidity and mortality than in children with tracheal stenosis alone.

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“…The mean error was 0.6 0.3 % for _ VO 2 detection and 1.8 0.3 % for _ VCO 2 detection during simulation of gas exchange expected in infants ranging from 0.5 to 10 kg body weight [13]. An in vitro validation of the SensorMedics 2900 Metabolic Cart (SensorMedics, Yorba Linda, Calif.), using neonatal respirator settings as in the present study, found small measurement errors for _ VO 2 , _ VCO 2 and RQ at tidal volumes above 100 ml at a ventilator frequency of 20/min [14]. However, at tidal volumes of 100 ml the error increased and tidal volumes of 50 ml resulted in unacceptable errors ranging from ±13.2 to ±21.3 % of predicted values.…”

Section: Discussion Of Methodsmentioning

confidence: 99%

In vitro validation of a metabolic monitor for gas exchange measurements in ventilated neonates

et al. 2000

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Objective: To evaluate the Datex Deltatrac II for measurements in neonates requiring mechanical ventilation. Design: Prospective laboratory evaluation, using a ventilated lung model and gas injection. During simulation of 79 neonatal respiratory settings, assessment of oxygen consumption (V Ç O 2 ), carbon dioxide production (V Ç CO 2 ) and respiratory quotient (RQ) was compared to a reference method (mass spectrometry, wet gas spirometry) using the statistical method of Bland and Altman. Interventions: Respiratory variables, which may influence the accuracy and precision of gas exchange measurements, were varied within the following ranges: inspired oxygen fraction (F I O 2 ): 0.21±0.8, expired carbon dioxide fraction (F E CO 2 ______ ) and inspiratory-expiratory oxygen fraction (DFO 2 ): 0.0032±0.0256, expiratory flow rate: 1.0±2.5 l/min, inspiratory pressure: 10±55 mbar, respiratory rate 25±60/min, constant RQ of 1. This resulted in 79 tests with V Ç CO 2 and V Ç O 2 ranging from 8±64 ml/min. Measurements and results: The coefficient of repeatability for ten single subsequent Deltatrac measurements was 8.09 ml/min for V Ç O 2 and 9.17 ml/min for V Ç CO 2 compared to 2.02 ml/min and 0.90 ml/min for V Ç O 2 and V Ç CO 2 with repeated reference measurements. The coefficient of repeatability of the Deltatrac measurements improved considerably when means of subsequent 5 min intervals were compared: 0.68 ml/min for V Ç O 2 and 0.28 ml/ min for V Ç CO 2 . The difference between the two methods (Deltatracreference) was ±3.8 % (2 s: 11.4 %) for V Ç O 2 , 13.2 % (2 s: 7.9 %) for V Ç CO 2 and 17.6 % (2 s: 16.7 %) for RQ. The agreement between methods deteriorated with smaller (F E CO 2 ______ ) or DFO 2 and increasing F I O 2 . Conclusions: Considering limits of agreement of less than 20 % as clinically acceptable, results for V Ç O 2 assessment indicate acceptable accuracy and precision whereas V Ç CO 2 and RQ assessments exceed this limit. Limited accuracy and precision result from detection of CO 2 following dilution of expiratory gases and increased sensitivity to error propagation by Haldane equations due to the small differences between inspiratory and expiratory gas fractions.

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An in vitro validation of a commercially available metabolic cart using pediatric ventilator volumes

Cited by 5 publications

References 22 publications

Effect of red blood cell transfusion on oxygen consumption in the anemic pediatric patient

Effect of red blood cell transfusion on oxygen consumption in the anemic pediatric patient

Treatment of tracheal stenosis with extracorporeal membrane oxygenation support in infants and newborns

In vitro validation of a metabolic monitor for gas exchange measurements in ventilated neonates

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