Is capnography on neonatal transport the answer?

Abstract

Is capnography on neonatal transport the answer?Upon delivery of any neonate, it is paramount to establish and maintain effective and adequate ventilation. For the majority of infants, this will take place with minimal assistance, if any is required at all. However, for some, this process will require resuscitative measures and may require prolonged support of respiration during and beyond transition from fetal to neonatal physiology. 1 When it is known prior to delivery that an infant is likely to require a higher level of care than can be safely provided outside of the neonatal intensive care unit (NICU) environment, it is ideal to plan for such a delivery to take place in a center where the anticipated needs of the infant can be met, eliminating the need for inter-hospital transport. However while ideal, this is not always feasible, and in some cases, the need for intensive care is unexpected. Therefore, there will always be neonates who require inter-hospital transport soon after delivery.

Navigating Pediatric Capnography: A Comprehensive Review of Scope and Limitations

“…The capnography waveform illustrates the CO2 levels throughout each respiratory cycle phase, providing a comprehensive ventilation assessment. Simultaneously, the numerical value, end-tidal carbon dioxide (ETCO2), typically falls within the range of [35][36][37][38][39][40][41][42][43][44][45]. This dual visual and numerical analysis approach enhances the precision of assessing respiratory function, making capnography an indispensable tool in pediatric care.…”

“…Moreover, the complexities of airway management and the elevated rates of intubation failure in neonatology compound the challenges associated with capnography implementation in this population [36]. While capnography is a routine tool for patient transport in older children and adults, its application in neonatal transport remains a subject of ongoing discussion and consideration [37]. Neonates' distinct physiological and clinical intricacies contribute to the deliberation surrounding the optimal utilization of capnography during their transport.…”