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

Heijden, Hylke H.A.C.M. Van Der; Truin, Gerben J.; Verhaeg, Joyce; Pol, Peggy van der; Lemson, Joris

doi:10.1111/pan.12827

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…Similar to Mehta et al, McDonald et al 13 demonstrated that increased lung disease had a negative effect on the PETCO 2 correlation with PaCO 2 . In contrast with previous studies, van der Heijden et al 17 reported that factors indicating severe lung disease did not adversely affect the relationship between ETCO 2 and PaCO 2 . However, they stated that this may be due to the high respiratory morbidity in their sample, resulting in relatively little variance in these parameters.…”

Section: Discussioncontrasting

confidence: 69%

“…4,6,13,16 In a study that examined the correlation between 341 PaCO 2 and ETCO 2 measurements of 47 patients who received MV, sidestream capnography in mechanically ventilated infants and children appeared to have moderate reliability and validity when corrected for individual differences. 17 Results of another study using sidestream capnography indicated that ETCO 2 gave an excellent value of the PaCO 2 in children older than 8 months. 18 Though mainstream capnography was used in our study, a significant correlation was found between the limited number of PaCO 2 and ETCO 2 , in accordance with the two aforementioned studies.…”

Section: Discussionmentioning

confidence: 96%

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Comparison of Simultaneous Capillary Blood Gases and End-Tidal Carbon Dioxide in Mechanically Ventilated Pediatric Patients with Acute Respiratory Failure

Konca

Tekin

Üçkardeş

et al. 2020

J Pediatr Intensive Care

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In the follow-up of ventilation, invasive blood gas analysis and noninvasive monitoring of end-tidal carbon dioxide (ETCO2) are used. We aimed to investigate the relationship between capillary partial pressure of carbon dioxide (PcCO2) levels and ETCO2 and also to investigate ETCO2's predictive feature of PcCO2 levels. This study included 28 female and 30 male pediatric patients; 28 patients were type-1 respiratory failure (RF), 16 patients were acute respiratory distress syndrome, and 14 patients were type-2 RF. Our results showed a significant correlation between ETCO2 and PcCO2. Although the strength of the correlation was weak throughout the measurements, the strength of this correlation increased significantly in type-2 RF.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 96%

Comparison of Simultaneous Capillary Blood Gases and End-Tidal Carbon Dioxide in Mechanically Ventilated Pediatric Patients with Acute Respiratory Failure

Konca

Tekin

Üçkardeş

et al. 2020

J Pediatr Intensive Care

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“…Both main- and side- stream capnographs are placed in-line with the ventilator circuit, between the ETT and ventilator tubing ( 10 ). The difference between them is where the CO 2 is analysed.…”

Section: Introductionmentioning

confidence: 99%

“…Clinical real-time interpretation of waveforms may identify life threatening complications of mechanical ventilation such as dislodged or blocked ETT (7), or describe established or impending lung pathologies (8). The CO 2 waveforms are more useful when evaluated with the concurrent flow, volume and pressure waveforms (9), although not all ventilators present them at a synchronous scale. This short overview aims to cover the practical basics of neonatal capnography, providing an for clinicians asking the following question: "In newborn infants requiring mechanical ventilation, what value does the capnography waveform have in supporting diagnosis and clinical troubleshooting?…”

Section: Introductionmentioning

confidence: 99%

Capnography waveforms: basic interpretation in neonatal intensive care

Williams,

Dassios,

Harris

et al. 2024

Front. Pediatr.

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End-tidal capnography can provide useful clinical information displayed on the ventilator screen or bedside monitor. It is important that clinicians can assess and utilise this information to assist in identifying underlying complications and pulmonary pathology. Sudden change or loss of the CO2 waveform can act as a safety measure in alerting clinicians of a dislodged or blocked endotracheal tube, considering the concurrent flow and volume waveforms. Visual pattern recognition by the clinicians of commonly seen waveform traces may act as an adjunct to other modes of ventilatory monitoring techniques. Waveforms traces can aid clinical management, help identify cases of ventilation asynchrony between the infant and the ventilator. We present some common clinical scenarios where tidal capnography can be useful in the timely identification of pulmonary complication and for practical troubleshooting at the cot-side.

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Assessment of sidestream end‐tidal capnography in ventilated infants on the neonatal unit

Williams

Dassios

Greenough

2020

Pediatric Pulmonology

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ObjectivesContinuous monitoring of carbon dioxide (CO2) levels can be achieved by capnography. Our aims were to compare the performance of a sidestream capnograph with a low dead space and sampling rate to a mainstream device and evaluate whether its results correlated with arterial/capillary CO2 levels in infants with different respiratory disease severities.Working HypothesesEnd‐tidal carbon dioxide (EtCO2) results by sidestream and mainstream capnography would correlate, but the divergence of EtCO2 and CO2 results would occur in more severe lung disease.Study DesignProspective cohort study.Patient‐subject SelectionFifty infants with a median (interquartile range) gestational age of 31.1 (27.1‐37.4) weeks and birth weight of 1.37 (0.76‐2.95) kg.MethodologyConcurrent measurements of EtCO2 in ventilated infants were made using a new Microstream sidestream device and a mainstream capnograph (gold standard). Results from both devices were compared with arterial or capillary CO2 levels. The ratio of dead space to tidal volume (Vd/Vt) was calculated to assess respiratory disease severity.ResultsThe mean difference between the concurrent measurements of EtCO2 was −0.54 ± 0.67 kPa (95% agreement levels − 1.86 to 0.77 kPa), the correlation between the two was r = .85 (P < .001). Sidestream capnography results correlated better with partial pressure of CO2 (PCO2) levels in infants with less (Vd/Vt < 0.35; r2 = .66, P < .001) rather than more severe (Vd/Vt > 0.35; r2 = .33, P = .01) lung disease.ConclusionsThe sidestream capnography performed similarly to the mainstream capnography. The poorer correlation of EtCO2 to PCO2 levels in infants with severe respiratory disease should highlight to clinicians increased ventilation‐perfusion mismatch.

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

Abstract: Sidestream capnography in mechanically ventilated infants and children seems moderately reliable and valid when corrected for individual differences. Therefore, it could only be used with caution for trend estimation in the individual patient.

Cited by 7 publications

References 15 publications

Comparison of Simultaneous Capillary Blood Gases and End-Tidal Carbon Dioxide in Mechanically Ventilated Pediatric Patients with Acute Respiratory Failure

Comparison of Simultaneous Capillary Blood Gases and End-Tidal Carbon Dioxide in Mechanically Ventilated Pediatric Patients with Acute Respiratory Failure

Capnography waveforms: basic interpretation in neonatal intensive care

Assessment of sidestream end‐tidal capnography in ventilated infants on the neonatal unit

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