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  • Title: Noninvasive monitoring of end-tidal CO2 via nasal cannulas in spontaneously breathing children during the perioperative period.
    Author: Tobias JD, Flanagan JF, Wheeler TJ, Garrett JS, Burney C.
    Journal: Crit Care Med; 1994 Nov; 22(11):1805-8. PubMed ID: 7956285.
    Abstract:
    OBJECTIVE: To determine the correlation between end-tidal CO2 and PaCO2 values measured via nasal cannulas in spontaneously breathing children during the perioperative period. DESIGN: Prospective evaluation. SETTING: Pediatric intensive/intermediate care unit in a tertiary care referral center. PATIENTS: Thirty postoperative surgical and trauma patients aged < or = 18 yrs (average age 7.8 yrs [range 6 months to 16 yrs] and average weight 28.3 kg (range 8.5 to 69). MEASUREMENTS AND MAIN RESULTS: Spontaneously breathing, nonintubated patients with an arterial cannula in place were selected for study. End-tidal CO2 was sampled from nasal cannulas by a sidestream aspirator and was estimated by infrared spectroscopy. The difference between PaCO2 and end-tidal CO2 was compared using linear regression analysis. A total of 55 blood gas measurements were obtained on the 30 patients. The PaCO2 to end-tidal CO2 gradient was < or = 4 torr in 54 of the 55 samples. The mean PaCO2 was 39.5 +/- 3.3 torr (5.27 +/- 0.44 kPa) with a mean end-tidal CO2 value of 39.7 +/- 3.8 torr (5.29 +/- 0.51 kPa). Linear regression analysis of arterial vs. end-tidal CO2 yielded a slope of 0.992 and p = .0001. CONCLUSIONS: End-tidal CO2 measurement by infrared spectroscopy provided an accurate estimation of PaCO2 in this patient population. Its use may limit the need for invasive monitoring and/or repeated arterial blood gas analysis.
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