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ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 3  |  Page : 768-772

Noninvasive assessment of arterial CO2 from end-tidal CO2 in pediatric intensive care unit of Al-Zahraa Hospital


1 Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
2 Department of Pediatrics, Dar Ismail Hospital, Alexandria, Egypt

Correspondence Address:
Assistant Professor Ragaa Abdel-Salam
Pediatric, Department, Faculty of Medicine, Al-Azhar University Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjamf.sjamf_101_19

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Background Arterial carbon dioxide tension (PaCO2) is considered to be the gold standard for accurate monitoring in pediatric ICU; however, it is invasive, costly, and intermittently gives snapshots about the patient status. Objective The aim was to use end-tidal carbon dioxide (ETCO2) as an effective, persistent, and non-invasive monitor of arterial CO2. Patients and methods This observational study was conducted on 50 mechanically ventilated children aged from 1 to 5 years in pediatric ICU of Al-Zahraa University Hospital. PaCO2 and ETCO2 were recorded at the same time, and the results were analyzed for correlation and agreement. Lung disease severity was measured by ventilation index (VI) and PaO2/FiO2 (P/F) ratio. Results This study showed that the mean PaCO2 was higher than ETCO2 value (31.32±14.49 and 29.79±13.81 mmHg, respectively). The mean difference between PaCO2 and ETCO2 was 1.8±3.23 mmHg. A positive correlation was present between both PaCO2 and ETCO2 (correlation coefficient r=0.969, P<0.001, and 95% confidence interval=0.946–0.982). A positive correlation was found between PaCO2 and ETCO2 in mild and moderate lung disease, where P/F ratio is greater than 200 (n=39, r=0.961, P<0.001) and VI is less than 20 (n=38, r=0.885, P<0.001), and also in severe lung disease, where P/F ratio is less than 200 (n=12, r=0.991, P<0.001) and VI is greater than 20 (n=12, r=0.988, P<0.001). Conclusion This study suggests a significant correlation between PaCO2 and ETCO2. ETCO2 monitoring exhibited a good validity to predict PaCO2 in critically ill children


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