Document Detail


Transcutaneous carbon dioxide monitoring during high-frequency oscillatory ventilation in infants and children.
MedLine Citation:
PMID:  12006797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Continuous monitoring of ventilation during mechanical ventilation may improve patient management by facilitating proactive rather than reactive ventilator adjustments and may decrease the need for repeated arterial blood gas analysis. Because of their more critical pulmonary status, patients requiring high-frequency oscillatory ventilation may especially benefit from continuous monitoring. DESIGN: Prospective evaluation of the correlation between transcutaneous CO2 (TC(CO2)) and PaCO2 values. SETTING: Tertiary care pediatric intensive care unit. PATIENTS: Fourteen pediatric patients receiving high-frequency oscillatory ventilation for severe respiratory failure. INTERVENTIONS: TC(CO2) was monitored continuously and compared with PaCO2 values when arterial blood gas analysis was performed. MEASUREMENTS AND MAIN RESULTS: One hundred sample sets were obtained from 14 patients age 1 day to 16 yrs (3.5 +/- 4.6 yrs) and weighing 3.1-85 kg (18.5 +/- 22.4 kg). The mean absolute difference between PaCO2 and TC(CO2) was 2.8 +/- 1.9 mm Hg. Regression analysis of TC(CO2) and PaCO2 values revealed a slope of 1.04, an r value of.96, and an r value of.94 (p <.0001). Bland-Altman analysis revealed a bias of 2.1 mm Hg with a precision of 2.7 mm Hg when TC(CO2) was compared with PaCO2 for the entire group. In the subgroup where PaCO2 was <or=50 mm Hg, the bias was 1.9 with a precision of 2.8, whereas when PaCO2 was >50 mm Hg, the bias was 2.3 with a precision of 2.6 (p = not significant). CONCLUSIONS: TC(CO2) monitoring provides an accurate and clinically acceptable estimate of PaCO2 over a wide range of CO2 values in pediatric patients during high-frequency oscillatory ventilation.
Authors:
John W Berkenbosch; Joseph D Tobias
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  30     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-13     Completed Date:  2002-06-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1024-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Child Health, University of Missouri, Columbia, MO, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Gas Monitoring, Transcutaneous*
Carbon Dioxide / blood*
Child
Child, Preschool
Female
High-Frequency Ventilation*
Humans
Infant
Infant, Newborn
Male
Partial Pressure
Prospective Studies
Respiratory Insufficiency / diagnosis
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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