title: Transcutaneous carbon dioxide monitoring during high-frequency oscillatory ventilation in infants and children.
abstract: OBJECTIVE
  Continuous monitoring of ventilation during mechanical ventilation may improve patient management by facilitating proactive rather than reactive ventilator adjustments and may decrease the need for repeated arterial blood gas analysis. Because of their more critical pulmonary status, patients requiring high-frequency oscillatory ventilation may especially benefit from continuous monitoring.
  
  
  METHODS
  Prospective evaluation of the correlation between transcutaneous CO2 (TC(CO2)) and PaCO2 values.
  
  
  METHODS
  Tertiary care pediatric intensive care unit.
  
  
  METHODS
  Fourteen pediatric patients receiving high-frequency oscillatory ventilation for severe respiratory failure.
  
  
  METHODS
  TC(CO2) was monitored continuously and compared with PaCO2 values when arterial blood gas analysis was performed.
  
  
  RESULTS
  One hundred sample sets were obtained from 14 patients age 1 day to 16 yrs (3.5 +/- 4.6 yrs) and weighing 3.1-85 kg (18.5 +/- 22.4 kg). The mean absolute difference between PaCO2 and TC(CO2) was 2.8 +/- 1.9 mm Hg. Regression analysis of TC(CO2) and PaCO2 values revealed a slope of 1.04, an r value of.96, and an r value of.94 (p <.0001). Bland-Altman analysis revealed a bias of 2.1 mm Hg with a precision of 2.7 mm Hg when TC(CO2) was compared with PaCO2 for the entire group. In the subgroup where PaCO2 was <or=50 mm Hg, the bias was 1.9 with a precision of 2.8, whereas when PaCO2 was >50 mm Hg, the bias was 2.3 with a precision of 2.6 (p = not significant).
  
  
  CONCLUSIONS
  TC(CO2) monitoring provides an accurate and clinically acceptable estimate of PaCO2 over a wide range of CO2 values in pediatric patients during high-frequency oscillatory ventilation.
authors: Department of Child Health, University of Missouri, Columbia, MO, USA.
authors: John W
authors: JW
authors: Berkenbosch
authors: Joseph D
authors: JD
authors: Tobias
mesh_terms: D000293:Adolescent; D001785:Blood Gas Monitoring, Transcutaneous; D002245:Carbon Dioxide / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010313:Partial Pressure; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000175:diagnosis
chemical_list: D002245:Carbon Dioxide