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Quantitative End-Tidal Carbon Dioxide Monitoring in the Delivery Room: A Randomized Controlled Trial.
MedLine Citation:
PMID:  23333003     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To investigate the utility of continuous quantitative end-tidal CO(2) (Etco(2)) monitoring for managing assisted ventilation in the delivery room (DR). STUDY DESIGN: This is a prospective randomized controlled trial. Infants who received positive pressure ventilation (PPV) were randomized to a control versus a monitored arm. In the monitored arm, the resuscitating team adjusted PPV based on Etco(2) values. In the control arm, the team provided PPV based on clinical assessment. Etco(2) levels after resuscitation and admission Pco(2) levels were compared between groups. RESULTS: Fifty infants were enrolled, and 48 subjects had primary outcome data. Of those, 7 infants were intubated in the DR, 41 infants received PPV via mask until respiratory support could be maintained on continuous positive airway pressure alone. The median Etco(2) levels at the end of resuscitation were 44 mm Hg (16-66 mm Hg) in the control arm and 43 mm Hg (29-59 mm Hg) in the monitored arm. The proportion of Etco(2) levels outside of the prespecified range was 52.6% (control) and 33.3% (monitored) (P = .236). The median admission Pco(2) levels were 57 mm Hg (36-110 mm Hg) in the control arm and 55 mm Hg (40-93 mm Hg) in the monitored arm. The proportion of admission Pco(2) levels outside of the prespecified range was 33.3% (control) versus 37.5% (monitored) (P = .763). CONCLUSIONS: Etco(2) monitoring in the DR did not reduce the proportion of admission Pco(2) levels outside of the prespecified range in a population of infants supported mostly with noninvasive ventilation.
Authors:
Juin Yee Kong; Wade Rich; Neil N Finer; Tina A Leone
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-16
Journal Detail:
Title:  The Journal of pediatrics     Volume:  -     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
Affiliation:
Division of Neonatology, Department of Pediatrics, University of California, San Diego, CA.
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