Comparison of end-tidal CO2 and Paco2 in children receiving mechanical ventilation.
OBJECTIVE: To determine whether end-tidal CO(2) (Petco(2)) measurement provides a reliable estimate of ventilation in critically ill children who are mechanically ventilated. DESIGN: Prospective, nonrandomized, consecutive enrollment study. SETTING: A university-affiliated children's hospital pediat...
| Publicado en: | Pediatric Critical Care Medicine Vol. 3; no. 3; pp. 244 - 250 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jul2002
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106508987&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106508987 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15297535 N1Y jtl: Pediatric Critical Care Medicine issn: 15297535 maglogo: N pubinfo: dt: Jul2002 vid: 3 iid: 3 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 106508987 106508987 NLM12780964 2009012478 10.1097/00130478-200207000-00008 NLM12780964 106508987 ppf: 244 ppct: 6 formats: tig: atl: Comparison of end-tidal CO2 and Paco2 in children receiving mechanical ventilation. aug: au: McDonald MJ Montgomery VL Cerrito PB Parrish CJ Boland KA Sullivan JE McDonald, Mark J. Montgomery, Vicki L. Cerrito, Patricia B. Parrish, Cindy J. Boland, Kimberly A. Sullivan, Janice E. affil: Division of Pediatric Critical Care, Department of Pediatrics (MJM, VLM, KAB, JES), and the Department of Mathematics, University of Louisville, Louisville, Kentucky; and Kosair Children's Hospital, Louisville, Kentucky sug: subj: Carbon Dioxide Respiration, Artificial Analysis of Variance Chi Square Test Child Confidence Intervals Convenience Sample Critically Ill Patients Intensive Care Units, Pediatric Linear Regression Prospective Studies Repeated Measures Human Child: 6-12 years ab: OBJECTIVE: To determine whether end-tidal CO(2) (Petco(2)) measurement provides a reliable estimate of ventilation in critically ill children who are mechanically ventilated. DESIGN: Prospective, nonrandomized, consecutive enrollment study. SETTING: A university-affiliated children's hospital pediatric intensive care unit. PATIENTS: All intubated, mechanically ventilated pediatric patients. INTERVENTIONS: All Petco(2)-Paco(2) pairs were from patients ventilated with a Servo 300 Ventilator (Siemens-Elema AB, Stockholm, Sweden). When a blood gas sample was obtained, Petco(2) as measured by a continuous mainstream Petco(2) capnograph was recorded. Measurements: The results of blood gas measurements and corresponding Petco(2) measurements were recorded. Demographic data and primary diagnosis were noted. Petco(2)-Paco(2) pairs obtained from patients with intracardiac shunts or obtained during high-frequency oscillation or extracorporeal membrane oxygenation at the time of measurement were excluded from analysis. Linear regression was used to analyze Petco(2)-Paco(2) pairs. Repeated measure analysis of variance with the mixed-model algorithm in SAS software (SAS Institute, Carey, NC) was used to analyze the trend in the Petco(2) and Paco(2) relationship. Chi-square was used to analyze categorical data. Statistical significance was considered p <.05. RESULTS: A total of 129 children were enrolled, and 1708 paired Paco(2) and Petco(2) measurements were recorded. The mean age +/- sd was 4.1 +/- 5.6 yrs. Paco(2) positively correlated with Petco(2). The linear equation for the regression analysis was y = 0.71x (95% confidence interval, 0.69-0.73) + 8.93 (95% confidence interval, 7.89-9.97), with r (2) =.716 and p <.001. The Petco(2)-Paco(2) difference was </=5 mm Hg (0.67 kPa) in 54% and </=10 mm Hg (1.33 kPa) in 80% of paired data. Increased lung disease had a negative effect on Petco(2) correlation with Paco(2). A total of 223 of 640 (35%) blood gases (defined by Pao(2)/Fio(2) ratio of <200) had >10 mm Hg (1.33 kPa) difference between the Petco(2) and Paco(2). However, only 111 of 1068 (10%) Petco(2)-Paco(2) pairs had a difference of >10 mm Hg (1.33 kPa) in patients with a Pao(2)/Fio(2) ratio >200. Trend analysis showed the Petco(2)-Paco(2) difference increased with increasing duration of mechanical ventilation. CONCLUSION: In most intubated, mechanically ventilated infants and children, Petco(2) reliably estimates ventilation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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