Validación de la medición transcutánea de la presión parcial de dióxido de carbono en el paciente crítico pediátrico

Miguel, S. Fernández de; Gáboli, Mirella; González-Celador, Rafael; Quero, P. Gómez de; Herrero, Viejo; Granados, José Manuel; Pérez, R. Payo

doi:10.1016/j.anpedi.2009.10.021

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Our findings are consistent with previously published studies performed in children, comparing either one or both alternative methods with PaCO 2 . Table 2 summarizes the most relevant published data 8,21–29 . Most trials were performed in patients during invasive ventilation, with ABGs obtained from arterial catheters during different clinical scenarios.…”

Section: Discussionmentioning

confidence: 99%

End‐tidal CO₂ and transcutaneous CO₂: Are we ready to replace arterial CO₂ in awake children?

Dicembrino

Barbieri

Pereyra

et al. 2020

Pediatric Pulmonology

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Introduction: Arterial blood gas analysis (ABG) is the gold standard test for carbon dioxide measurement. End-tidal PCO 2 (PetCO 2) and transcutaneous PCO 2 (PtcCO 2) are noninvasive alternative methods. Objective: To examine the use of PetCO 2 and PtcCO 2 as PaCO 2 surrogates in awake children. Methods: A prospective observational study. Consecutive awake children in a stable condition referred to the Sleep Unit of Hospital de Pediatría Dr. J. P. Garrahan with suspected or confirmed sleep-related respiratory disorders requiring ABG were included. PetCO 2 and PtcCO 2 were recorded simultaneously during arterial puncture. PetCO 2 and PtCO 2 values were compared with PaCO 2. Correlation coefficient and Bland-Altman analysis were applied. The sample size was calculated considering a mean difference ≤3 mmHg as clinically acceptable. Results: Sixty-eight sample sets were obtained from 67 patients. The median age was 9.11 years (0.23-18.76). During 94.1% of the procedures patients breathed spontaneously, 30% needed multiple punctures and 92% resulted in pain. Median (IQR) PaCO 2 (mmHg) was 36.3 (31.45; 40.90), PetCO 2 33.0 (29; 39) and PtcCO 2 38.8 (32.95; 43.32). Correlation and agreement for PaCO 2 /PetCO 2 and PaCO 2 / PtcCO 2 was r = .6 and .9, and media of bias = 2.83 (−9.97; 15.64) and −1.88 (−9.01; 5.24), respectively. Hypercapnia (PaCO 2 > 45.0 mmHg) was present in 8/68 (11.8%) samples. Sensitivity, specificity, positive predictive value and negative predictive value to detect hypercapnia with PetCO 2 was 38%, 98%, 75%, and 92%, respectively, and with PtcCO 2 , 100%, 90%, 57%, and 100%, respectively. Conclusion: PtcCO 2 showed better agreement with PaCO 2 than PetCO 2 but because of the wide dispersion of values, neither method can replace the gold standard. Transcutaneous CO 2 might be a good screening tool to detect hypercapnia in awake children.

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Section: Discussionmentioning

confidence: 99%

End‐tidal CO₂ and transcutaneous CO₂: Are we ready to replace arterial CO₂ in awake children?

Dicembrino

Barbieri

Pereyra

et al. 2020

Pediatric Pulmonology

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“…In our study, the skin at the flexor Original Article side of brachioradialis was monitored to obtain stable and accurate data. It has been indicated that TcPCO2 can accurately (11)(12)(13)(14)(15) predict Pa-CO2 in a real-time manner (4), and has been widely used (8). The most important thing is that TcPCO2 is a valuable supplement to PETCO2 monitoring in patients with a large gap between PaCO2 and PETCO2 and in those concurrently requiring continuous accurate non-invasive control of CO2 levels (4,8,9).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Strategies for Hypercarbia in Elderly Patients Undergoing Prolonged Retroperitoneoscopic Surgery ——The Role of TcPCO2 and PEEP

Kong¹,

Xiao²,

Xu³

et al. 2014

J Anesth Perioper Med

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Diagnostic and therapeutic strategies for hypercarbia in elderly patients undergoing prolonged retroperitoneoscopic surgery -the role of TcPCO2 and PEEP. J Anesth Perioper Med 2014; 1: 63-71.Background: Retroperitoneal laparoscopy provides less operation injury and faster postoperative recovery. However, long-term pneumoperitoneum increases the risk of hypercapnia that may induce severe postoperative complications, especially in elderly patients. Our study aims at investigating the sensitivity and reliability of continuous transcutaneous carbon dioxide (TcPCO2) monitoring in diagnosing hypercapnia during retroperitoneoscopic surgery in elderly patients and evaluating the effect of positive end-expiratory pressure (PEEP) against retroperitoneum induced hypercapnia. Methods: Fifty-five patients aged over 65 years who were scheduled for selective retroperitoneoscopic surgery under general anesthesia were enrolled. The correlations between TcPCO2, end-tidal partial pressure of CO2 (PETCO2) and arterial CO2 (PaCO2) were evaluated before pneumoperitoneum as well as 30 and 60 minutes after establishment of pneumoperitoneum (time 0, 1 and 2), respectively. Patients were randomly assigned to 5 groups accepting different levels of PEEP: 0, 4, 6, 8 and 10 cm H2O (group I, II, III, IV and V). PaCO2 and PETCO2 were measured at 80 minutes following pneumoperitoneum (time 3). Heart rate (HR), arterial pressure, airway pressure were evaluated throughout surgery. Results: There was a significant correlation between TcPCO2 and PaCO2 (r=0.87, P< 0.01), but the correlation between PETCO2 and PaCO2 was lessened with prolonged pneumoperitoneum. The consistency limit (mean ± 2SD) between PaCO2 vs. TcPCO2 and PaCO2 vs. PETCO2 was (-2.86, 5.46) and (-1.61, 20.11) mm Hg, respectively. A difference of ≤5 mm Hg happened in 96% results of PaCO2 vs. TcPCO2 and 32% of PaCO2 vs. PETCO2 (P<0.01). After the use of PEEP, the PaCO2 was increased in group I and II, sustained in group III, but decreased in group IV and V (P<0.05). In addition, PEEP restored the correlation between PETCO2 and PaCO2(r=0.6, P<0.01, N= 55). The hypercapnia induced enhancement of mean arterial pressure (MAP) and HR was normalized by 10 cm H2O PEEP although the airway plateau pressure (PPLAT) and airway pressure peak (PPEAK) values were elevated. Conclusions: TcPCO2 may be used as an alternative non-invasive monitoring to predict the PaCO2 levels in elderly patients undergoing long-term retroperitoneoscopic surgery. PEEP (10 cm H2O) combined with low tidal volume (VT=7 ml/kg) ventilation provides a therapeutic approach to ameliorate pneumoperitoneum-induced hypercapnia in these patients.

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“…Los resultados de nuestra muestra no son comparables al artículo de Fernández de Miguel S. et al 12 , dada la diferencia en el rango de edad, pero si estamos de acuerdo que utilizando el sensor para la medición de la PtCO 2 con el anillo de fijación y el cumplimiento de un protocolo riguroso, hacen más fiables los valores obtenidos para en el rango de edad de nuestros pacientes.…”

Section: Discussionunclassified

Correlación de los valores de pCO2 obtenidos por gasometría arterial y capnografía transcutánea

Martín

Ortega

2013

Sanid. Mil.

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ARTÍCULO ORIGINAL INTRODUCCIÓNLa gasometría arterial es actualmente el método más exacto 1 , empleado para la medición de los valores de la presión arterial de Oxígeno (PaO 2 ), presión parcial de anhídrido carbónico (pCO 2 ), y el equilibrio ácido-base del organismo. Informa del estado de oxigenación de la sangre arterial, del grado de ventilación pulmonar y del equilibrio ácido base del organismo. Es por

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Validación de la medición transcutánea de la presión parcial de dióxido de carbono en el paciente crítico pediátrico

Cited by 4 publications

References 19 publications

End‐tidal CO₂ and transcutaneous CO₂: Are we ready to replace arterial CO₂ in awake children?

End‐tidal CO₂ and transcutaneous CO₂: Are we ready to replace arterial CO₂ in awake children?

Diagnostic and Therapeutic Strategies for Hypercarbia in Elderly Patients Undergoing Prolonged Retroperitoneoscopic Surgery ——The Role of TcPCO2 and PEEP

Correlación de los valores de pCO2 obtenidos por gasometría arterial y capnografía transcutánea

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Validación de la medición transcutánea de la presión parcial de dióxido de carbono en el paciente crítico pediátrico

Cited by 4 publications

References 19 publications

End‐tidal CO2 and transcutaneous CO2: Are we ready to replace arterial CO2 in awake children?

End‐tidal CO2 and transcutaneous CO2: Are we ready to replace arterial CO2 in awake children?

Diagnostic and Therapeutic Strategies for Hypercarbia in Elderly Patients Undergoing Prolonged Retroperitoneoscopic Surgery ——The Role of TcPCO2 and PEEP

Correlación de los valores de pCO2 obtenidos por gasometría arterial y capnografía transcutánea

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End‐tidal CO₂ and transcutaneous CO₂: Are we ready to replace arterial CO₂ in awake children?

End‐tidal CO₂ and transcutaneous CO₂: Are we ready to replace arterial CO₂ in awake children?