While arterial blood gas analysis is the gold standard for PaCO 2 monitoring, it requires a painful collection procedure, is expensive and can lead to iatrogenic anaemia 6 due to repeated collection of samples, thereby increasing the need of transfusion, while only providing information on discrete timepoints.Ī possible alternative is transcutaneous monitoring of the partial pressure of CO 2 (TcCO 2), but using this method in young children is complicated due to the immaturity of the skin, the need of repeated calibration and the risk of burns and infections, 7,8 leaving aside that it is not available in most neonatal intensive care units (NICUs) in Spain.Įnd-tidal CO 2 (ETCO 2) monitoring is a useful alternative. 3,4 At the same time, fluctuations in PaCO 2 are associated with poorer neurodevelopmental outcomes. Monitoring of the arterial partial pressure of carbon dioxide (PaCO 2) in ill newborns, especially those who require ventilation, is important to optimise patient management and prevent complications, since both hypocapnia and hypercapnia are known contributors to periventricular leukomalacia, 1,2 intracranial haemorrhage 3 and bronchopulmonary dysplasia. Asimismo, observamos errores sistemáticos de signo diferente (positivo o negativo) entre las instituciones.

La correlación entre ETCO y PCO2 es significativa, si bien los valores obtenidos no resultan equivalentes y la diferencia varía entre 0,1 mmHg a 20 mmHg.

Los valores promedios de ETCO 2 y PCO 2 fueron de 41.36 mmHg y 42.04 mmHg, Hubo correlación positiva y significativa entre ETCO 2 y PCO 2 en el análisis global (r = 0,5402 p ETCO 2) en 2 de las unidades mientras que en la tercera la diferencia fue negativa (PCO 2 < ETCO 2) Discusión Se analizaron 277 muestras (ETCO 2 / PCO 2) en 83 recién nacidos. Se realizaron análisis de correlación y gráficos de Bland Altman para estimar la concordancia. La medición de ETCO 2 se realizó mediante un ventilador neonatal Graph Net Neo – TECME®, con capnógrafo incorporado y se obtuvo el gradiente ETCO 2 – PCO 2. Se incluyeron recién nacidos internados que requerían ventilación mecánica convencional. ObjetivoĮvaluar la relación entre la ETCO 2 y la PCO 2 en recién nacidos MétodosĮstudio de corte transversal, comparativo entre dos métodos de medición de PCO 2, el convencional mediante análisis de muestras sanguíneas y el estimado mediante ETCO 2. La medición de CO 2 espirada (ETCO 2) es una alternativa poco implementada en esta población. Monitorear la presión parcial de CO 2 (PCO 2) en los recién nacidos que requieren ventilación permitiría evitar hipocapnia e hipercapnia. Likewise, we found systematic errors that differed in sign (positive or negative) between institutions. The correlation between ETCO and PCO 2 was significant, although the obtained values were not equivalent, with differences ranging from 0.1 mmHg and 20 mmHg. There was a positive and significant correlation between ETCO 2 and PCO 2 in the overall analysis ( r = 0.5402 P ETCO 2) in 2 of the units, and a negative difference in the third (PCO 2 < ETCO 2). The mean values of ETCO 2 and PCO 2 were 41.36 mmHg and 42.04 mmHg. ResultsĪ total of 277 samples (ETCO 2 / PCO 2) from 83 newborns were analyzed. We conducted correlation and Bland-Altman plot analyses to estimate the agreement.

The ETCO 2 was measured with a Tecme GraphNet® neo, a neonatal ventilator with an integrated capnograph, and we obtained the ETCO 2–PCO 2 gradient. The study included hospitalized newborns that required conventional mechanical ventilation. MethodsĬross-sectional study comparing two PCO 2 measurement methods, the conventional one by analysis of blood samples and the one estimated by ETCO 2. To evaluate the relationship between ETCO 2 and PCO 2 in newborns. The measurement of end-tidal carbon dioxide (ETCO 2) is an alternative rarely implemented in this population. Monitoring the partial pressure of CO 2 (PCO 2) in newborns who require ventilation would allow avoiding hypocapnia and hypercapnia.

Normal end tidal co2 pediatric