Document Detail


Measurement of gastric-to-end-tidal carbon dioxide difference in neonates requiring intensive care.
MedLine Citation:
PMID:  22348539     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: Gastric-arterial partial CO(2) pressure gap (P(g-a)CO(2) gap) measured by gastric tonometry may detect the disturbance of splanchnic perfusion. Since in the neonatal age it is very difficult to follow up the circulatory condition with frequent acid-base examinations, we wanted to compare the P(g-a)CO(2) gap with an alternative gap of P(g)CO(2)- end-tidal carbon dioxide (P(g)(-ET)CO(2)gap). Methods: A prospective study was performed on ventilated neonates requiring intensive therapy (n=44, weight: 1813±977 g). P(ET)CO(2) and P(g)CO(2) were measured with a side stream capnograph. We applied a newly developed gastric tonometric probe. Patients were divided into group 1 of patients in stable condition (n=35) and group 2 of patients with severe condition (i.e. CRIB score higher than 10; n=9). For main statistical analysis a mixed model repeated measurements ANOVA, Bland-Altman analysis were applied. Results: P(g)(-ET)CO(2)gap was higher than P(g-a)CO(2) gap (11.40±7.79 versus 3.63±7.98 mmHg, p<0.01). Both gaps were higher in group 2 (8.71±10.89 and 18.27±10.49 versus 2.53±6.78 and 9.92±6.22 mmHg, p<0.01 and p<0.05). Bland-Altman analysis of the two gaps showed an acceptable correspondence. Conclusions: P(g)(-ET)CO(2) gap may be used as a method for continuous estimation of splanchnic perfusion and a prognostic index also in critically ill neonates. However, the P(g-a)CO(2) gap should not be abandoned.
Authors:
Orsolya Szakál; Agnes Király; Dániel Szűcs; Márta Katona; Domokos Boda; Gyula Tálosi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-21
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Paediatrics, University of Szeged, Hungary.
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