Transcutaneous Carbon Dioxide Monitoring with Reduced-Temperature Probes in Very Low Birth Weight Infants.
BackgroundObtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO2) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO2monitoring using reduced-temperature probes (41°C).ObjectiveThe objective of this study was to assess reliability and safety of tcPCO2monitoring at reduced-temperature probe in VLBW infants.Design and MethodsA prospective study was conducted on VLBW infants. tcPCO2was monitored for 12 hours. Default skin probe temperature was adjusted at 41°C. Blood gases were done as clinically indicated. Arterial partial pressure of CO2(PaCO2) as well as capillary CO2were compared with simultaneous tcPCO2.ResultsA total of 124 data points were identified from 50 patients (gestational age [GA] = 28.1 ± 2.4 weeks and birth weight [BW] = 1,035 ± 291 g). Patients were supported with continuous positive airway pressure (40%), noninvasive positive pressure ventilation (16%), mechanical ventilation (18%), and high-frequency oscillation ventilation (24%). PaCO2was measured using either capillary (58%) or arterial (42%) samples. Mean CO2did not differ between tcPCO2(51.3 ± 16) and PaCO2(49.1 ± 13.7) mm Hg. tcPCO2showed positive correlation with partial pressure of CO2(r= 0.6,p< 0.001). This correlation continued to be significant after controlling for GA, postmenstrual age, type of sample, and pH. No skin complications were reported.ConclusiontcPCO2monitoring using a temperature of 41°C is feasible and reliable in VLBW infants.
Department of Pediatrics, Children's National Medical Center, The George Washington University, Washington, District of Columbia.
Safwat
S
Aly
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Mohamed
M
El-Dib
Division of Newborn Services, Children's National Medical Center, The George Washington University, Washington, District of Columbia.
Mohamed
M
Mohamed
Division of Newborn Services, Children's National Medical Center, The George Washington University, Washington, District of Columbia.
Hany
H
Aly
D001785:Blood Gas Monitoring, Transcutaneous / Q000009:adverse effects / Q000379:methods*; D002245:Carbon Dioxide / Q000032:analysis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D010313:Partial Pressure; D011446:Prospective Studies; D015203:Reproducibility of Results; D013696:Temperature
D002245:Carbon Dioxide