Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates

Arterial blood gas analysis is the gold standard for assessing the adequacy of ventilation. However, arterial blood sampling may be associated with serious complications in neonates. The aim of the study was to utilize the side-stream capnometry measurement of end-tidal carbon dioxide (PetCO2) via n...

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Main Authors: Chih-Che Tai, Frank Leigh Lu, Pau-Chung Chen, Suh-Fang Jeng, Hung-Chieh Chou, Chien-Yi Chen, Po-Nien Tsao, Wu-Shiun Hsieh
Format: Article
Language:English
Published: Elsevier 2010-12-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957210600642
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author Chih-Che Tai
Frank Leigh Lu
Pau-Chung Chen
Suh-Fang Jeng
Hung-Chieh Chou
Chien-Yi Chen
Po-Nien Tsao
Wu-Shiun Hsieh
author_facet Chih-Che Tai
Frank Leigh Lu
Pau-Chung Chen
Suh-Fang Jeng
Hung-Chieh Chou
Chien-Yi Chen
Po-Nien Tsao
Wu-Shiun Hsieh
author_sort Chih-Che Tai
collection DOAJ
description Arterial blood gas analysis is the gold standard for assessing the adequacy of ventilation. However, arterial blood sampling may be associated with serious complications in neonates. The aim of the study was to utilize the side-stream capnometry measurement of end-tidal carbon dioxide (PetCO2) via nasal cannula circuits and to verify the reliability of PetCO2 in reflecting the arterial blood carbon dioxide (PaCO2) level in nonintubated neonates. Methods: A retrospective medical record review analysis was performed in nonintubated neonates admitted to the neonatal ward in a medical center. Simultaneous arterial PaCO2 and PetCO2 levels were evaluated. PaCO2 and PetCO2 levels were compared by paired t test and were correlated using Pearson's correlation. The PetCO2 bias was defined as the difference between PaCO2 and PetCO2, and was assessed by Bland-Altman plot analysis. Results: A total of 34 neonates were recruited, and data of 54 pairs of PaCO2 and PetCO2 levels were available for comparison. The average (mean ± SD) gestational age was 32.5 ± 4.2 weeks, and the average birth weight was 1881 ± 1077 g. There was a good correlation between PetCO2 and PaCO2 levels among all paired samples (r = 0.809, p < 0.001). When the data were divided into those with respiratory disease (n = 34) and those without (n = 20), significant correlation between PetCO2 and PaCO2 levels were both noted in the former group (r = 0.823, p < 0.001) and the latter group (r = 0.770, p < 0.001). The overall average mean value of PetCO2 was lower than that of PaCO2 (39.4 ± 8.8 mmHg vs. 41.3 ± 9.2 mmHg, p = 0.014). The difference between PetCO2 and PaCO2 levels was significant only among those with respiratory disease (38.8 ± 9.8 mmHg vs. 41.2 ± 10.3 mmHg, p = 0.027), but not among those without (40.5 ± 7.0 mmHg vs. 41.6 ± 7.2 mmHg, p = 0.289). Conclusions: End-tidal CO2 measurement by side-stream capnometry through nasal cannula could provide an accurate and noninvasive estimate of PaCO2 levels in nonintubated neonates.
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spelling doaj-art-b69a4ddc2f2b431f868f430360653aea2025-08-20T02:00:38ZengElsevierPediatrics and Neonatology1875-95722010-12-0151633033510.1016/S1875-9572(10)60064-2Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated NeonatesChih-Che Tai0Frank Leigh Lu1Pau-Chung Chen2Suh-Fang Jeng3Hung-Chieh Chou4Chien-Yi Chen5Po-Nien Tsao6Wu-Shiun Hsieh7Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanInstitute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, TaiwanSchool and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanArterial blood gas analysis is the gold standard for assessing the adequacy of ventilation. However, arterial blood sampling may be associated with serious complications in neonates. The aim of the study was to utilize the side-stream capnometry measurement of end-tidal carbon dioxide (PetCO2) via nasal cannula circuits and to verify the reliability of PetCO2 in reflecting the arterial blood carbon dioxide (PaCO2) level in nonintubated neonates. Methods: A retrospective medical record review analysis was performed in nonintubated neonates admitted to the neonatal ward in a medical center. Simultaneous arterial PaCO2 and PetCO2 levels were evaluated. PaCO2 and PetCO2 levels were compared by paired t test and were correlated using Pearson's correlation. The PetCO2 bias was defined as the difference between PaCO2 and PetCO2, and was assessed by Bland-Altman plot analysis. Results: A total of 34 neonates were recruited, and data of 54 pairs of PaCO2 and PetCO2 levels were available for comparison. The average (mean ± SD) gestational age was 32.5 ± 4.2 weeks, and the average birth weight was 1881 ± 1077 g. There was a good correlation between PetCO2 and PaCO2 levels among all paired samples (r = 0.809, p < 0.001). When the data were divided into those with respiratory disease (n = 34) and those without (n = 20), significant correlation between PetCO2 and PaCO2 levels were both noted in the former group (r = 0.823, p < 0.001) and the latter group (r = 0.770, p < 0.001). The overall average mean value of PetCO2 was lower than that of PaCO2 (39.4 ± 8.8 mmHg vs. 41.3 ± 9.2 mmHg, p = 0.014). The difference between PetCO2 and PaCO2 levels was significant only among those with respiratory disease (38.8 ± 9.8 mmHg vs. 41.2 ± 10.3 mmHg, p = 0.027), but not among those without (40.5 ± 7.0 mmHg vs. 41.6 ± 7.2 mmHg, p = 0.289). Conclusions: End-tidal CO2 measurement by side-stream capnometry through nasal cannula could provide an accurate and noninvasive estimate of PaCO2 levels in nonintubated neonates.http://www.sciencedirect.com/science/article/pii/S1875957210600642capnometryend-tidal carbon dioxidenasal cannulaneonate
spellingShingle Chih-Che Tai
Frank Leigh Lu
Pau-Chung Chen
Suh-Fang Jeng
Hung-Chieh Chou
Chien-Yi Chen
Po-Nien Tsao
Wu-Shiun Hsieh
Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates
Pediatrics and Neonatology
capnometry
end-tidal carbon dioxide
nasal cannula
neonate
title Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates
title_full Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates
title_fullStr Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates
title_full_unstemmed Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates
title_short Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates
title_sort noninvasive capnometry for end tidal carbon dioxide monitoring via nasal cannula in nonintubated neonates
topic capnometry
end-tidal carbon dioxide
nasal cannula
neonate
url http://www.sciencedirect.com/science/article/pii/S1875957210600642
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