Comparison of end-tidal carbon dioxide and arterial blood bicarbonate levels in patients with metabolic acidosis referred to emergencymedicine

Abstract

Introduction: The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis. Methods: In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated. Results: Mean of ETco2 and Hco3 levels in patients with metabolic acidosis were 22.29 ± 4.15 and 12.78 ± 3.83, respectively. In all patients, the significant direct linear relationship was found between ETco2 with Hco3 (r = 0.553, P < 0.001). We had 4 groups of patients with metabolic acidosis, also there is a significant direct linear relationship between the ETCo2 and the Hco3 level of arterial blood in patients with renal failure (P < 0.001 and r = 0.551), sepsis (P < 0.001 and r = 0.431), drug toxicity (P < 0.001 and r = 0.856), and ketoacidosis (DKA) (P < 0.001 and r = 0.559). Conclusion: According to the results of this study, capnography can be used for primary diagnosis of metabolic acidosis in spontaneously breathing patients who referred to the emergency wards, however, the ABG must be considered as the gold standard tool for diagnosis and guiding the treatment.

Decreased oxygen saturation levels in neonates with transposition of great arteries: Impact on appearance of cerebral veins in susceptibility-weighted imaging

“…revealed a significant correlation between high etCO 2 and cerebral blood flow with weak venous contrast in SWI 35 in spontaneously breathing patients sedated with propofol. Since etCO 2 and blood bicarbonate levels show a significant correlation 36 , blood CO 2 might have influenced the CVA in our study. The difference between etCO 2 and PaCO 2 is stated to be 2–5 mm Hg with higher values for PaCO 2 37 .…”

Bicarbonate Therapy for Critically Ill Patients with Metabolic Acidosis: A Systematic Review

“…Capnography is the primary diagnostic method of metabolic acidosis in spontaneously breathing patients referred to the emergency wards. However, arterial blood gas is the gold standard tool for diagnosis, the results of which guide the treatment [24]. Metabolic acidosis affects the cardiovascular, respiratory, metabolic, cerebral, renal, haematological, endocrine, musculoskeletal, and immunological systems [25][26][27][28][29].…”

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial

“…However, based on evidence, this process is not without risk factors (Lakhal and Robert-Edan 2017). The process of inserting arterial line (over 48 or 72 hours) is an invasive procedure with several complications, for instance infection, local hematoma, vascular injury, thrombosis, disseminated intravascular coagulation, and reduced cardiac output (Sood et al 2010, Long et al 2017, Taghizadieh et al 2016). On the other hand, Iran, as a developing country with sanctions, cannot access advanced medical equipment, such as ABG analyzers.…”