Continuous pH and PCO2 monitoring during respiratory failure in children with the Paratrend 7 inserted into the peripheral venous system

Tobias, Joseph D.; Connors, Dean F.; Strauser, Lynne M.; Johnson, Tiffanie R.

doi:10.1067/mpd.2000.104293

Cited by 17 publications

(5 citation statements)

References 16 publications

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“…The correlation of pH, pO 2 , BE, and bicarbonate between VBG and CBG was comparable to previous studies in neonates and pediatric patients ( 4 , 6 , 15 – 17 ). By contrast, while we observed a good correlation of pCO 2 between VBG and CBG, this correlation varied between studies ( 4 , 6 , 15 , 16 , 21 ).…”

Section: Discussionsupporting

confidence: 89%

“…The venous pH, BE, and bicarbonate were for more than 88% interchangeable and therefore a reliable substitute for CBG, similar to previous results of pediatric and adults studies ( 4 , 6 , 17 , 22 , 23 ). However, the interchangeability of pCO 2 (72%) was lower in our study when compared to the 90% in pediatric and adults studies ( 4 , 17 , 23 ). It is difficult to explain this difference in pCO 2 while the other parts of the measurements were similar.…”

Section: Discussionsupporting

confidence: 87%

“…To determine interchangeability, a Bland–Altman analysis was performed, based on the 95% limits of agreement (LoA), estimated by mean difference (bias) ±2 SD of the differences, that provides a 95% confidence interval of the differences between VBG and CBG are expected to lie. Clinically acceptable difference for each blood gas value was defined up-front by means of an absolute difference: pH (±0.05), pCO 2 (±0.66 kPa = 5 mmHg), pO 2 (± 0.66 kPa = 5 mmHg), BE (±3 mmol/l/), and bicarbonate (±3 mmol/l), based on bias of reference values of infant’s blood gas ( 11 , 20 ) and former studies ( 5 , 6 , 17 ). The oxygen saturation of our blood gasses are estimated values, not measured by co-oximetry, and was not included in our analyses.…”

Section: Methodsmentioning

confidence: 99%

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Correlation and Interchangeability of Venous and Capillary Blood Gases in Non-Critically Ill Neonates

et al. 2018

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BackgroundVenous blood gas (VBG) is frequently used in the neonatal unit as alternative for capillary blood gas (CBG). However, studies reporting correlation are conflicting and data on interchangeability in neonates are lacking.ObjectiveWe investigated the correlation and interchangeability of the components between VBG and CBG in infants admitted to the neonatal intensive care unit.MethodsIn a prospective study in the neonatal unit in Leiden University Medical Center (Netherlands), simultaneously VBG and CBG were withdrawn in neonates when both venous puncture and intravenous access as blood gas monitoring was indicated. From each blood gas analysis, a Pearson correlation, intraclass correlation, and Bland–Altman analysis was performed. Clinically acceptable difference for each blood gas value was defined up-front by means of an absolute difference: pH ± 0.05; partial pressure of carbon dioxide (pCO2) (±0.67 kPa = 5 mmHg); partial pressure of oxygen (pO2) (±0.67 kPa = 5 mmHg); base excess ± 3 mmol/l; and bicarbonate (HCO3−) ± 3 mmol/l.ResultsIn 93 patients [median gestational age 31 (IQR 29–34) weeks], 193 paired samples of VBG and CBG were collected. The Pearson correlation between VBG and CBG was very strong for pH (r = 0.79; P < 0.001), BE (r = 0.90; P < 0.001) and bicarbonate (r = 0.87; P < 0.001); strong for pCO2 (r = 0.68; P < 0.001); and moderate for pO2 (r = 0.31; P < 0.001). The percentage of the interchangeability within our acceptable absolute difference for pH was 88%, pCO2 72%, pO2 55%, BE 90%, and bicarbonate 94%.ConclusionVBG and CBG in neonates are well correlated and mostly interchangeable, except for pO2.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

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Correlation and Interchangeability of Venous and Capillary Blood Gases in Non-Critically Ill Neonates

et al. 2018

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“…By placing the Paratrend sensor through either a PA or central venous catheter, it was possible to obtain a continuous measurement of pH and pCO 2 . Although we have previously demonstrated that the Paratrend can be inserted through a peripheral vein [4,5,7], no peripheral access could be obtained in these three patients.…”

Section: Discussionmentioning

confidence: 98%

“…A limitation of the device when used in infants and children is the need for a 20‐gauge arterial cannula for placement. To overcome this problem, we previously demonstrated that the Paratrend can be placed through a peripheral venous cannula (20 or 22 gauge) to continuously measure venous blood gas values and give a clinically acceptable estimation of arterial pCO 2 and pH [4,5]. However, this latter technique still requires the maintenance of peripheral venous access, which may be problematic in small neonates and infants.…”

mentioning

confidence: 99%

Continuous pH and pCO2 Monitoring Using the Paratrend Inserted Through a Pulmonary Artery or Central Venous Catheter

Tobias

2001

J Intensive Care Med

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The Paratrend continuous blood gas monitoring system was placed through a pulmonary artery or central venous catheter as a means of continuously monitoring pH, pCO2, and mixed venous oxygen saturation in three neonates at risk for cardiorespiratory dysfunction, two following surgery for congenital heart disease and one with septic shock. After calibration with an arterial/mixed venous blood gas value, the Paratrend monitor provided a clinically useful continuous measurement of pH and pCO2. The difference between the Paratrend and the arterial values for pH and pCO2 were 0.02 ± 0.009 and 2.4 ± 0.8 mmHg, respectively. There was a significant discrepancy between the oxygen saturation reading from the Paratrend and the actual measured mixed venous value (9 ± 5%). The possible applications of the Paratrend placed through a pulmonary artery or central venous catheter are discussed.

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Sidestream microstream end tidal carbon dioxide measurements and blood gas correlations in neonatal intensive care unit

Singh

Gilbert

Singh

et al. 2012

Pediatric Pulmonology

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Continuous pH and PCO2 monitoring during respiratory failure in children with the Paratrend 7 inserted into the peripheral venous system

Cited by 17 publications

References 16 publications

Correlation and Interchangeability of Venous and Capillary Blood Gases in Non-Critically Ill Neonates

Correlation and Interchangeability of Venous and Capillary Blood Gases in Non-Critically Ill Neonates

Continuous pH and pCO2 Monitoring Using the Paratrend Inserted Through a Pulmonary Artery or Central Venous Catheter

Sidestream microstream end tidal carbon dioxide measurements and blood gas correlations in neonatal intensive care unit

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