Noninvasive capnometry monitoring for respiratory status during pediatric seizures.
OBJECTIVE
To determine the reliability and clinical value of end-tidal CO2 by oral/nasal capnometry for monitoring pediatric patients presenting post ictal or with active seizures.


METHODS
Clinical, prospective, observational study.


METHODS
University affiliated children's hospital.


METHODS
One hundred sixty-six patients (105 patients with active seizures, 61 post ictal patients) had end-tidal CO2 obtained by oral/nasal sidestream capnometry, and respiratory rates, oxygen saturation, and pulse rates recorded every 5 mins until 60 mins had elapsed. End-tidal CO2 values were compared with a capillary PCO2 and clinical observation.


RESULTS
The mean end-tidal CO2 reading was 43.0 +/- 11.8 torr [5.7 +/- 1.6 kPa] and the mean capillary PCO2 reading was 43.4 +/- 11.7 torr [5.7 +/- 1.6 kPa]. The correlation between end-tidal CO2 and capillary PCO2 was significant (r2 = .97; p < .0001). A relative average bias of 0.33 torr (0.04 kPa) with end-tidal CO2 lower than capillary PCO2 was established with 95% limits of agreement +/-4.2 torr (+/-0.6 kPa). Variability of difference scores was not related to range of mean scores (r2 = .00003), age (r2 = .0004), or respiratory rates (r2 = .0009). End-tidal CO2 (r2 = .22; p < .001) correlated better with respiratory rate changes when compared with oxygen saturation (r2 = .02; p = .01).


CONCLUSIONS
Dependable end-tidal CO2 values can be obtained in pediatric seizure patients using an oral/nasal cannula capnometry circuit. Continuous end-tidal CO2 monitoring provides the clinician with a reliable assessment of pulmonary status that can assist with decisions to provide ventilatory support.
Abramo
T J
TJ
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235-9063, USA.
Wiebe
R A
RA
Scott
S
S
Goto
C S
CS
McIntire
D D
DD
D000293:Adolescent; D001784:Blood Gas Analysis; D019296:Capnography / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D008176:Lung Volume Measurements; D008297:Male; D008991:Monitoring, Physiologic; D010092:Oximetry; D011446:Prospective Studies; D015203:Reproducibility of Results; D012119:Respiration / Q000502:physiology*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D012640:Seizures / Q000503:physiopathology*