Document Detail

Non-invasive accurate measurement of arterial PCO(2) in a pediatric animal model.
MedLine Citation:
PMID:  23100168     Owner:  NLM     Status:  Publisher    
The PCO(2) in arterial blood (PaCO(2)) is a good parameter for monitoring ventilation and acid-base changes in ventilated patients, but its measurement is invasive and difficult to obtain in small children. Attempts have been made to use the partial pressure of CO(2) in end-tidal gas (PETCO(2)), as a noninvasive surrogate for PaCO(2). Studies have revealed that, unfortunately, the differences between PETCO(2) and PaCO(2) are too variable to be clinically useful. We hypothesized that end-inspiratory rebreathing, previously shown to equalize PETCO(2) and PaCO(2) in spontaneously breathing humans, would also be effective with positive pressure ventilation. Eight newborn Yorkshire pigs were mechanically ventilated via a partial rebreathing circuit to implement end-inspiratory rebreathing. Arterial blood was sampled and tested for PaCO(2). A variety of alveolar ventilations resulting in different combinations of end-tidal PCO(2) (30-50 mmHg) and PO(2) (35-500 mmHg) were tested for differences between PETCO(2) and PaCO(2) (PET-aCO(2)). The PET-aCO(2) of all samples was (mean ± 1.96 SD) 0.4 ± 2.7 mmHg. Our study demonstrates that, in ventilated juvenile animals, end-inspiratory rebreathing maintains PET-aCO(2) to what would be a clinically useful range. If verified clinically, this approach could open the way for non-invasive monitoring of arterial PCO(2) in critically ill patients.
Jorn Fierstra; Jeff D Winter; Matthew Machina; Jelena Lukovic; James Duffin; Andrea Kassner; Joseph A Fisher
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-26
Journal Detail:
Title:  Journal of clinical monitoring and computing     Volume:  -     ISSN:  1573-2614     ISO Abbreviation:  J Clin Monit Comput     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9806357     Medline TA:  J Clin Monit Comput     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Neurosurgery, University Health Network, Toronto, ON, Canada,
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