Diagnostic accuracy of capnography during high‐frequency ventilation in neonatal intensive care units

Abstract

Our prospective study suggests that continuous dCap in infants ventilated with HFV may be helpful for trends and alarm for unsafe levels of PaCO2 . dCap is only a complimentary tool and cannot replace PaCO2 sampling because the agreement between these measurements was less than adequate.

Correlation of End-Tidal Carbon Dioxide with Arterial Carbon Dioxide in Mechanically Ventilated Neonates: A Scoping Review

“…In general, the correlation and agreement between CO 2 from non-invasive methods with arterial blood 31 EtCO 2 / PaCO 2 : IG 28-32 s: r = 0.73, P < .01/IG 32-37 s: r = 0.61, P < .001/IG 37-41 s: r = 0.81, P < .001/<1.5 kg: r = 0.62, P < .01/−1.5-2.5 kg: r = 0.92, P < .001; >2.5 kg: r = 0.81, P < .001/MAS: r = 0.94, P < .001/Severe asphyxia: r = 0.76, P < .001/Recurrent apnea: r = 0.96, P < .001/RDS: r = 0.55, P < .01-0.001 Rozycki et al 26 EtCO 2 /PaCO 2 : r = 0.833, P < .001; AG: −6.9 ± 6.9 mmHg (CI 95%: ±11.5 mmHg) Wu et al 32 PetCO 2 /PaCO 2 : r = 0.818, P < .001; AG: 3. 37 dCap/PaCO 2 : r = 0.7, P < .001; AG: −11.7 ± 10.3 mmHg Kugelman et al 38 dEtCO 2 /PaCO 2 : r = 0.73, P < .001; AG: 3 ± 8.5 mmHg Lin et al 24 PetCO 2 /PaCO 2 : r = 0.603, P < .01; AG: 5.9 ± 7.6 mmHg Nakato et al 29 EtCO 2 /PaCO 2 : r = 0.853, P < .001; AG: 0.352 ± 7.57 mmHg (CI 95%: 14. gases showed to be strong/high in this review, although moderate and weak/low values were found. Noninvasive methods can help indicate considerable changes in PaCO 2 levels to avoid excessive blood sampling and reduce the exposure time to hypocapnia and hypercapnia.…”

“…31 About lung diseases, in 2 studies the correlation was greater in newborns with RDS using surfactant than in those who did not use it. 6,24 In 2 studies, newborns with moderate and severe lung disease maintained a strong high correlation, 29,37 and in only one, the correlation was moderate in the presence of SDR. 31 Details about the statistical tests, the correlation and agreement values are shown in Table 3, and the conclusion of the results are shown in Table 4.…”

“…Meredith and Monaco 30 Strong correlation and high agreement Nangia et al 31 Strong correlation: birth weight between 1.5 e 2.5 kg, MAS, recurrent apnea, premature infants of 28-32 s, Term NBs, >2.5 kg and severe asphyxia; Moderate correlation : premature infants (32-37 s), birth weight <1.5 kg e RDS Rozycki et al 26 Strong correlation and low agreement Wu et al 32 Strong correlation and low agreement Aliwalas et al 27 Moderate correlation Singh and Singhal 25 Strong correlation and high agreement Kugelman et al 33 Strong correlation and high agreement for the distal method; Weak correlation and low agreement for the proximal method Bernet et al 34 Low agreement Bhat andAbhishek 6 Strong correlation and high agreement Kugelman et al 28 Strong correlation and high agreement Trevisanuto et al 22 Strong correlation and low agreement Singh et al 35 Moderate correlation and low agreement Tingay et al 36 High concordance Mukhopadhyay et al 23 Moderate agreement Kugelman et al 37 Strong correlation and low agreement Kugelman et al 38 Strong correlation and high agreement Lin et al 24 Moderate correlation and low agreement Nakato et al 29 Strong correlation and high agreement Abbreviations: RDS, respiratory distress syndrome; MAS, meconium aspiration syndrome.…”

Is waveform capnography reliable in neonates?

“…Rapid variations, when seen in clinical practice, make an unreliable basis on which to make a decision to change ventilator settings. Kugelman et al compared ETCO 2 and PaCO 2 during HFOV in two studies 18 19. Mainstream capnography produced no meaningful values, likely owing to no end expiratory plateau phase.…”

Pediatric pulmonology year in review 2016: Part 2

“…Minute ventilation and tidal volume cannot be measured, and capnography has been limited to transcutaneous CO 2 measurements, which have been problematic in very premature newborns that may not tolerate the skin temperatures that until very recently have been required for accurate measurement. Kugelman et al evaluated capnography using a 2‐lumen endotracheal tube and microstream capnography correlated with arterial blood gas measurements obtained from an indwelling line. Although accuracy was not acceptable, capnography was able to predict very low P a CO 2 < 30 Torr and very high P a CO 2 above 60 Torr.…”