Reproducibility of the respiratory dead space measurements in mechanically ventilated children using the CO2SMO monitor.
OBJECTIVE
To assess the reproducibility of respiratory dead space measurements in ventilated children.


METHODS
Prospective study.


METHODS
University pediatric intensive care unit.


METHODS
Thirty-two mechanically ventilated children (0.13-15.4 years) who were clinically stable.


METHODS
The single-breath CO(2) test (SBT-CO(2)) was recorded using the CO(2)SMO Plus from the mean of 30 ventilatory cycles during 1 h (at T0, T15, T30, T45, and T60). Airway dead space was determined automatically (Novametrix Medical Systems, USA), and manually by Bohr- Enghoff equations using data obtained by SBT-CO(2). At the end of the study period, arterial blood gas was sampled in order to calculate alveolar and physiologic dead space. Intrasubject reproducibility of measurements was evaluated by the intraclass correlation coefficient. Two-way analysis of variance was used to evaluate the relationships between time and measurements. The two methods for calculating airway dead space were compared by using two-tailed Student's t-test and Bland-Altman analysis.


RESULTS
Airway dead space measurement had a good reproducibility during the 1-h period, whatever the method used (intraclass correlation coefficient: 0.84 to 0.87). No significant difference was observed with time. Airway dead space values from the SBT-CO(2) method were smaller than those from Bohr-Enghoff equations. Physiologic dead space values from the SBT-CO2 method were similar to those from Bohr-Enghoff equations.


CONCLUSIONS
The measurement of airway dead space by the CO(2)SMO Plus was reproducible over a 1-h period in children requiring mechanical ventilation, provided ventilatory parameters were constant throughout the study. SBT-CO(2) analysis may provide a bedside non-invasive monitoring of volumetric capnography.
Riou
Y
Y
Department of Respiratory Physiology, University Hospital of Lille, Lille, France.
Leclerc
F
F
Neve
V
V
Dupuy
L
L
Noizet
O
O
Leteurtre
S
S
Sadik
A
A
D000293:Adolescent; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000503:physiopathology; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000379:methods*; D012126:Respiratory Dead Space / Q000502:physiology*
D002245:Carbon Dioxide