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Capnography in Pediatric Critical Care Unit and Correlation of End-Tidal and Arterial Carbon Dioxide in Ventilated Children
Abstract Recording of end-tidal carbon dioxide (EtCO 2 ) noninvasively reflects a real-time estimation of arterial carbon dioxide (PaCO 2 [partial pressure of CO 2 ]). However, as the EtCO 2 is dependent on metabolism, perfusion, and ventilation, predicting PaCO 2 from EtCO 2 is not linear. The obje...
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| Published in: | Journal of child science 2020-01, Vol.10 (1), p.e80-e86 |
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| Main Authors: | , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
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| Online Access: | Get full text |
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| Summary: | Abstract
Recording of end-tidal carbon dioxide (EtCO
2
) noninvasively reflects a real-time estimation of arterial carbon dioxide (PaCO
2
[partial pressure of CO
2
]). However, as the EtCO
2
is dependent on metabolism, perfusion, and ventilation, predicting PaCO
2
from EtCO
2
is not linear. The objective of the study was to find out the predictability of PaCO
2
from EtCO
2
in PICU and to evaluate the factors affecting the correlation of EtCO
2
and PaCO
2
in critically ill ventilated children. The design involved was prospective observational study. The setting discussed over here is that of pediatric intensive care unit (PICU) of tertiary care hospital. A total of 160 children between 1 month and 14 years received mechanical ventilation. EtCO
2
, PaCO
2
, PaO
2
/FiO
2
(PF) ratio, oxygenation index (OI), and ventilation index (VI) are the factors involved in main outcome measures. A total of 535 pairs of EtCO
2
and PaCO
2
were recorded in 160 ventilated children during the stable hemodynamic state. Mean age and weight (
Z
-score) of patients were 31.15 ± 40.46 months and −2.10 ± 1.58, respectively. EtCO
2
and PaCO
2
differences were normal (2–5 mm of Hg) in 393 (73.5%) pairs. High gradient (>5 mm of Hg) was mostly found with children with pneumonia, prolonged ventilation, and pressure mode of ventilation (
p
20) adversely affected the relationship with poor correlation coefficient (
r
= 0.449, 95% CI = 0.30, 0.58 and
r
= 0.227, 95% CI = 0.03, 0.41, respectively). EtCO
2
reading showed good validity to predict PaCO
2
and not affected by oxygenation parameters. The correlation was affected by the presence of pneumonia and high ventilation index; hence it is recommended to monitor PaCO
2
invasively in these patients till a good correlation is established. |
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| ISSN: | 2474-5871 2474-5871 |
| DOI: | 10.1055/s-0040-1714114 |