Estimation of arterial carbon dioxide by end-tidal and transcutaneous PCO2 measurements in ventilated children. 1992

Y Sivan, and M K Eldadah, and T E Cheah, and C J Newth
Division of Pediatric Intensive Care, Childrens Hospital Los Angeles, CA 90027.

Simultaneous measurements of arterial, end-tidal, and transcutaneous carbon dioxide (PaCO2, PetCO2, PtcCO2, respectively) were obtained in 134 children receiving mechanical ventilation (ages, 2 days to 16 years; mean, 2.5 years). The mean +/- SD PetCO2 bias (PaCO2 - PetCO2) was 3.4 +/- 6.6 mmHg. When the PetCO2 bias was plotted against the PaO2/PAO2 ratio, a change in the scatter was obvious at about 0.3. The PetCO2 bias for patients with PaO2/PAO2 under 0.3 was 7.8 +/- 7.3 mmHg compared to 0 +/- 3.4 in patients with PaO2/PAO2 above 0.3 (P less than 0.001). PetCO2 differed significantly from PaCO2 (P less than 0.001) only for patients with PaO2/PAO2 under 0.3. The slope (PaCO2 versus PetCO2) for these patients was 1.59, while the slope for patients with PaO2/PAO2 above 0.3 coincided with the line of identity (1.00). The mean +/- SD PtcCO2 bias (PaCO2 - PtcCO2) was -1.3 +/- 7.2 mmHg. Skin perfusion was recorded at the area close to the transcutaneous CO2 monitor electrode and was defined as normal when capillary refill was below 3 seconds. The PtcCO2 bias for patients with normal skin perfusion was -0.2 +/- 5.4 mmHg (P = 0.73) compared to -4.1 +/- 9.9 for patients with decreased skin perfusion (P = 0.01). The slope of PtcCO2 against PaCO2 was closer to identity in patients with normal skin perfusion (1.17) than in patients where it was decreased (slope, 1.40). We suggest that PaCO2 estimation by both PetCO2 and PtcCO2 is sufficiently precise and reliable for clinical use in critically ill children. Certain limitations stem from the nature of the techniques.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D001785 Blood Gas Monitoring, Transcutaneous The noninvasive measurement or determination of the partial pressure (tension) of oxygen and/or carbon dioxide locally in the capillaries of a tissue by the application to the skin of a special set of electrodes. These electrodes contain photoelectric sensors capable of picking up the specific wavelengths of radiation emitted by oxygenated versus reduced hemoglobin. Carbon Dioxide Partial Pressure Determination, Transcutaneous,Cutaneous Oximetry,Oximetry, Transcutaneous,Oxygen Partial Pressure Determination, Transcutaneous,Transcutaneous Blood Gas Monitoring,Transcutaneous Capnometry,Transcutaneous Oximetry,PtcO2,TcPCO2,Capnometries, Transcutaneous,Capnometry, Transcutaneous,Cutaneous Oximetries,Oximetries, Cutaneous,Oximetries, Transcutaneous,Oximetry, Cutaneous,Transcutaneous Capnometries,Transcutaneous Oximetries
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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