Monitoring of end tidal carbon dioxide and transcutaneous carbon dioxide during neonatal transport
D G Tingay, M J Stewart, C J Morley, D G Tingay, M J Stewart, C J Morley
Abstract
Objective: To assess the accuracy of measurements of end tidal carbon dioxide (CO2) during neonatal transport compared with arterial and transcutaneous measurements.
Design: Paired end tidal and transcutaneous CO2 recordings were taken frequently during road transport of 21 ventilated neonates. The first paired CO2 values were compared with an arterial blood gas. The differences between arterial CO2 (Paco2), transcutaneous CO2 (TcPco2), and end tidal CO2 (Petco2) were analysed. The Bland-Altman method was used to assess bias and repeatability.
Results: Petco2 correlated strongly with Paco2 and TcPco2. However, Petco2 underestimated Paco2 at a clinically unacceptable level (mean (SD) 1.1 (0.70) kPa) and did not trend reliably over time within individual subjects. The Petco2 bias was independent of Paco2 and severity of lung disease.
Conclusions: Petco2 had an unacceptable under-recording bias. TcPco2 should currently be considered the preferred method of non-invasive CO2 monitoring for neonatal transport.
References
- Anesthesiology. 1990 Aug;73(2):265-8
- Pediatrics. 1998 Apr;101(4 Pt 1):648-53
- Crit Care Med. 1986 Dec;14(12):1050-2
- Can J Anaesth. 1991 Mar;38(2):201-3
- J Perinatol. 1998 May-Jun;18(3):189-92
- Lancet. 1986 Feb 8;1(8476):307-10
- Can J Anaesth. 1990 Apr;37(3):318-21
- Pediatr Pulmonol. 1992 Mar;12(3):153-7
- Pediatrics. 1995 Jun;95(6):875-8
- J Clin Monit. 1991 Oct;7(4):285-8
- Can J Anaesth. 1992 Jul;39(6):617-32
- Can J Anaesth. 1991 Nov;38(8):1072-4
- Acta Anaesthesiol Scand Suppl. 1995;107:87-90
- Arch Dis Child. 1987 Aug;62(8):837-9
- Anesthesiology. 1988 Jul;69(1):112-6
- Arch Dis Child Fetal Neonatal Ed. 2002 Jul;87(1):F7-F10
- Pediatr Crit Care Med. 2002 Jul;3(3):244-249
- Anesth Analg. 1997 Jul;85(1):55-8
- Pediatrics. 1992 Jun;89(6 Pt 1):1042-4
Source: PubMed