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

Singh, Bindya S.; Gilbert, Urquidez; Singh, Sharad; Govindaswami, Balaji

doi:10.1002/ppul.22593

Cited by 42 publications

(40 citation statements)

References 23 publications

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“…[14] Similarly, other studies conducted in very low birth weight infants (VLBWI) with severe lung disease by sidestream–microstream capnograph revealed less reliable correlation and mean bias 13.5 ± 8.4 (95% agreement levels 3-29.9 mmHg). [1516] Among infants and children, our study found an excellent positive correlation between EtCO 2 and PaCO 2 , but severe lung disease as defined by P/F ratio <200 had a negative impact on this relationship. Similar to this, Macdonald[12] et al .…”

Section: Discussionmentioning

confidence: 62%

Correlation of end tidal and arterial carbon dioxide levels in critically Ill neonates and children

Mehta¹,

Kashyap²,

Trivedi³

2014

Indian Journal of Critical Care Medicine

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Aim of the Study:End tidal carbon dioxide (EtCO2) monitoring is considered to reflect real-time estimation of partial pressure of carbon dioxide in arterial blood (PaCO2) noninvasively. However, knowledge about its relationship with PaCO2 in critically ill pediatric and neonatal patients is limited. The primary objective was to evaluate predictive capability of end tidal carbon dioxide monitoring and secondary objective was to determine the influence of severity of lung disease on EtCO2 and PaCO2 relationship.Materials and Methods:This was a prospective, nonrandomized, consecutive enrollment study carried out in neonatal and pediatric intensive care units of a tertiary care children hospital. It was conducted in 66 neonates and 35 children receiving mechanical ventilation. Severity of lung disease was estimated by ventilation index and PaO2/FiO2 (P/F) ratio. Simultaneous recording of EtCO2 and PaCO2 levels was done and data were analyzed for correlation and agreement.Results:In neonates, 150 EtCO2 and PaCO2 pairs were recorded. The mean weight ± SD of patients was 2.1 ± 0.63 kg. PaCO2 had a positive correlation with EtCO2 (r = 0.836, 95% CI = 0.78-0.88). P/F ratio <200 adversely affected relationship. In infants and children, 96 pairs were recorded. Mean age ± SD of patients was 4.20 ± 4.92 years and mean weight ± SD was 13.1 ± 9.49 kg. PaCO2 had an excellent correlation with EtCO2 (r = 0.914, 95% CI = 0.87 and 0.94). P/F ratio <200 adversely affected relationship.Conclusion:EtCO2 monitoring displayed a good validity to predict PaCO2. Correlation was affected by low P/F ratio (<200); hence, it is recommended that blood gases be measured in these patients until such time that a good relation can be established between end tidal and arterial CO2 values.

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Section: Discussionmentioning

confidence: 62%

Correlation of end tidal and arterial carbon dioxide levels in critically Ill neonates and children

Mehta¹,

Kashyap²,

Trivedi³

2014

Indian Journal of Critical Care Medicine

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“…Three studies report similar results of sidestream capnography in a neonatal population (8,11,12). Two other studies report better accuracy of sidestream measurement in a neonatal population (13,14).…”

Section: Discussionmentioning

confidence: 81%

“…This population suffers from problematic respiratory diffusion, ventilation of dead space, and shunting due to atelectasis. Earlier research showed that the Pa O2 /Fi O2 ratio and ventilation index had a significant influence on the relationship between Et CO2 and Pa CO2 measurements (1,2,(5)(6)(7)(8)(9). There are two methods of capnography.…”

mentioning

confidence: 99%

Validity of sidestream endtidal carbon dioxide measurement in critically ill, mechanically ventilated children

Heijden

Truin

Verhaeg

et al. 2015

Pediatric Anesthesia

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“…Recent studies on the accuracy of capnography in neonates show correlation coefficients between endtidal CO 2 (ET CO 2 ) and PaCO 2 between 0.72 and 0.95. However, this correlation decreases substantially in subgroups with a high-physiologic dead space ventilation (severe lung disease, very-low-birth-weight neonates), in which the difference between ET CO 2 and arterial measured PaCO 2 can increase to 17.8 AE 6.7 mmHg (57)(58)(59)(60). Although the ET CO 2 value is in general lower than the corresponding PaCO 2 value, in some patients, the ET CO 2 overestimates the PaCO 2 .…”

Section: Hypocapnia and The Brainmentioning

confidence: 99%

Beyond survival; influences of blood pressure, cerebral perfusion and anesthesia on neurodevelopment

McCann

Schouten

2013

Pediatric Anesthesia

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Neonates have a higher perioperative mortality risk largely due to the degree of prior illness of the infants, the complexity of their surgeries, and infant physiology. It is important to consider contributing anesthetic factors during the perioperative period that may affect cerebral perfusion and neurocognitive outcome, such as alterations in hemodynamics and ventilation. Limitations of blood pressure as a marker for cerebral perfusion are discussed, as well as the effect of hypocapnia on the brain.

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

Cited by 42 publications

References 23 publications

Correlation of end tidal and arterial carbon dioxide levels in critically Ill neonates and children

Correlation of end tidal and arterial carbon dioxide levels in critically Ill neonates and children

Validity of sidestream endtidal carbon dioxide measurement in critically ill, mechanically ventilated children

Beyond survival; influences of blood pressure, cerebral perfusion and anesthesia on neurodevelopment

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