Capnometry during neonatal transport—Mini review

Abstract

Monitoring critically ill, ventilated neonates during ground or air inter-hospital transport can be challenging. Pulse oximetry is an established non-invasive method to continuously monitor oxygenation, but there is also a need to monitor ventilation by assessing the clearance of carbon dioxide. Monitoring carbon dioxide levels is essential as both hypocarbia and hypercarbia in term and preterm infants are associated with lung and brain morbidities (bronchopulmonary dysplasia, peri/intraventricular haemorrhage and cystic periventricular leukomalacia). [1][2][3][4][5][6] Obtaining blood gases (incl. pCO 2; partial pressure of carbon dioxide), the gold standard method in neonatal intensive care, is not feasible during neonatal transport. Therefore, alternative methods of carbon dioxide monitoring need to be considered. They include the measurement of partial pressure of end-tidal carbon dioxide (etCO 2 ), also called capnometry. Apart from continuous carbon dioxide monitoring, a valuable feature of capnometry is rapid recognition of accidental extubation, which makes capnometry-together with its noninvasiveness, portability, and relative inexpensiveness-suitable

Is capnography on neonatal transport the answer?

“…Review, the single most important benefit of capnography during transport of a neonate is validation of the intubated trachea. 5 Despite the presence of significant leaks around the ETT, the capnometer confirms ETT placement. In contrast, a standard colorimetric CO 2 detector is only used for brief visual confirmation of successful intubation, it is not intended to be used long term.…”

“…As mentioned in Capnometry during Neonatal Transport: Mini Review, the single most important benefit of capnography during transport of a neonate is validation of the intubated trachea 5 . Despite the presence of significant leaks around the ETT, the capnometer confirms ETT placement.…”