The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

COMPARISON OF END TIDAL CARBON DIOXIDE MONITORING AND ARTERIAL BLOOD GAS SAMPLING IN THE NEONATAL INTENSIVE CARE UNIT



Alicia Muirhead, RRT-NPS, NE Georgia Medical Center, Gainesville, GA. Lynda T. Goodfellow, Ed.D., RRT, Georgia State University, Atlanta, GA. USA

Background:Due to recent advances in the treatment of neonates, end-tidal CO2 monitoring is becoming a realistic tool for evaluation. In previous years end-tidal CO2 monitoring was not commonly used in the neonatal population due to ventilation-perfusion mismatching and the lack of sensitivity of monitoring equipment. Better monitoring equipment and the use of surfactant replacement therapy could improve the utility of continuous non-invasive monitoring. Continuous non-invasive monitoring of end-tidal CO2 could reduce the number of arterial blood draws necessary in treatment of neonates and alert the clinician to conditions of hypercarbia and hypocarbia for more rapid correction.

Objective: To determine the precision and accuracy of end-tidal/arterial CO2 pairs as well as the ability to detect trends toward hypocarbia and hypercarbia using end-tidal CO2 monitoring in NICU patients.

Design: Comparison of nonrandomized samples of arterial CO2 with end-tidal CO2 measurements.

Setting:
Level Two Neonatal Intensive Care Unit.

Patients: Eleven newborn infants receiving mechanical ventilation in the neonatal intensive care unit with indwelling arterial catheter access. All infants were less than 30 days of age and above 1000 grams in weight.

Outcome measures:
The correlation coefficient was determined for the CO2 pairs. The average range between end-tidal and arterial CO2 pairs was also reported.

Results
: Thirty-six arterial/end-tidal CO2 pairs were obtained from eleven patients. The correlation coefficient was 0.799. The minimum range between end-tidal CO2 measurements and the arterial CO2 was zero mmHg and the maximum range was 16 mmHg. The average range was 4.45 mmHg.

Conclusion:
End-tidal CO2 measurements are highly correlated to arterial CO2 values. End-tidal CO2 monitoring may be useful in trending arterial CO2 values in ventilated neonates.

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