Monitoring of end tidal carbon dioxide and transcutaneous carbon dioxide during neonatal transport

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 90; no. 6; pp. F523 - F526
• Main Authors: Tingay, D G, Stewart, M J, Morley, C J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.11.2005; BMJ Publishing Group LTD; BMJ Group
• Subjects: alveolar-arterial oxygen tension ratio; arterial partial pressure of carbon dioxide; Blood Gas Monitoring, Transcutaneous; Capnography; Carbon dioxide; Carbon Dioxide - analysis; Carbon Dioxide - blood; end tidal partial pressure of carbon dioxide; Humans; Infant Care - methods; Infant, Newborn; mechanical ventilation; monitoring; Monitoring, Physiologic - methods; Neonates; NETS; NETS, Newborn Emergency Transport Service (Victoria); Newborn babies; Newborn Emergency Transport Service (Victoria); Original; Original articles; Pa; Paco2; PAo2/Pao2 ratio; Partial Pressure; Pet; Petco2; ratio, alveolar-arterial oxygen tension ratio; Reproducibility of Results; Respiration, Artificial; Respiratory Insufficiency - blood; Respiratory Insufficiency - metabolism; Respiratory Insufficiency - therapy; TcP; TcPco2; transcutaneous partial pressure of carbon dioxide; transportation; Transportation of Patients; Trends; Ventilation; Ventilators; United States > US
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/adc.2004.064717

Objective: To assess the accuracy of measurements of end tidal carbon dioxide (CO2) during neonatal transport compared with arterial and transcutaneous measurements. Design: Paired end tidal and transcutaneous CO2 recordings were taken frequently during road transport of 21 ventilated neonates. The first paired CO2 values were compared with an arterial blood gas. The differences between arterial CO2 (Paco2), transcutaneous CO2 (TcPco2), and end tidal CO2 (Petco2) were analysed. The Bland-Altman method was used to assess bias and repeatability. Results: Petco2 correlated strongly with Paco2 and TcPco2. However, Petco2 underestimated Paco2 at a clinically unacceptable level (mean (SD) 1.1 (0.70) kPa) and did not trend reliably over time within individual subjects. The Petco2 bias was independent of Paco2 and severity of lung disease. Conclusions: Petco2 had an unacceptable under-recording bias. TcPco2 should currently be considered the preferred method of non-invasive CO2 monitoring for neonatal transport.