Key result
ET CO2 monitoring in ventilated children reveals negative PaCO2-ETCO2 gaps in ~71% of samples.
Why the study?
Capnography (ET CO2) is routinely used to estimate arterial CO2 levels during mechanical ventilation in children, but the occurrence and predictors of negative arterial to end-tidal CO2 differences are not well understood.
Does capnography accurately estimate arterial carbon dioxide levels in children undergoing mechanical ventilation during general anaesthesia?
Population
799 children undergoing general anaesthesia with mechanical ventilation
Comparison
Arterial CO2 (Pa CO2) vs end-tidal CO2 (ET CO2) measurements
Design
Retrospective observational analysis
Authors
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Negative ETCO2-PaCO2 gaps occur in anesthetized children; leaves open reliability of capnography assumptions for pediatric ventilation guidance.
Observational (n=799)
Does capnography accurately estimate arterial carbon dioxide levels in children undergoing mechanical ventilation during general anaesthesia?
Mean Difference: -0.18 (95% CI -1.1–0.74)
In children undergoing mechanical ventilation during general anaesthesia, ETCO2 monitoring frequently overestimates PaCO2, challenging the assumption of a positive gap and posing a risk of unrecognized hypocarbia.
Onodi et al. (2017) conducted an observational in Undergoing general anaesthesia with mechanical ventilation of the lungs (n=799). Mechanical ventilation during general anaesthesia was evaluated on Arterial to end-tidal carbon dioxide difference (MD -0.18 kPa, 95% CI -1.10 to 0.74). ET CO2 monitoring in mechanically ventilated children demonstrated a mean arterial to end-tidal carbon dioxide difference of -0.18 kPa, with 71.2% of samples showing negative values.
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