| Non-invasive accurate measurement of arterial PCO(2) in a pediatric animal model. | |
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MedLine Citation:
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PMID: 23100168 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jorn Fierstra; Jeff D Winter; Matthew Machina; Jelena Lukovic; James Duffin; Andrea Kassner; Joseph A Fisher |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-26 |
Journal Detail:
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Title: Journal of clinical monitoring and computing Volume: - ISSN: 1573-2614 ISO Abbreviation: J Clin Monit Comput Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9806357 Medline TA: J Clin Monit Comput Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Division of Neurosurgery, University Health Network, Toronto, ON, Canada, jornfierstra@gmail.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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