Abstract
We have examined the reliability of end-tidal carbon dioxide (PetCO2) monitoring as an estimate of arterial carbon dioxide tension (PaCO2) in spontaneously breathing infants and children. Forty patients were studied in the post-anaesthetic care unit; 20 < 12 kg and 20 ≥12 kg. ThePetCO2 was sampled via a 5 cm 16 gauge catheter taped below an external naris and this measurement was compared with the PaCO2 of a sample drawn from an indwelling arterial line. Twenty additional patients were studied during inhalational anaesthesia. ThePetCO2 was measured both from the proximal end of the elbow connector and from a 5 cm cannula inserted through the elbow. An arterial blood gas sample was obtained simultaneously. The arterial to end-tidal (Pa-ET) differences were compared between the two sites. Patients studied in the post-anaesthetic care unit showed good correlation betweenPetCO2 and PaCO2 regardless of weight: Pa-EtCO2 of −0.6 ±3.6 (< 12 kg) and −1.1 ±2.8 mm Hg (≥12 kg). Patients studied during mask anaesthesia showed better correlation betweenPetCO2 and PaCO2 whenPetCO2 was sampled from thte cannula: Pa-ETCO2 of 3.5 ±4.8 mm Hg (cannula), 8.6 ±4.5 (elbow) (P < 0.05). These results suggest that end-tidal CO2 monitoring is a useful and reliable method for assessing adequacy of ventilation in spontaneously breathing children weighing between 5.2 and 35 kg.
Résumé
Cette étude vise à évaluer, en ventilation spontanée, la fiabilité du monitorage du CO2 téléexpiratoire (PetCO2) comme mesure de la tension du gaz carbonique artériel (PaCO2) chez des nourrissons et des enfants. Une étude est réalisée d’abord à l’unité des soins postopératoires chez 40 patients: 20 < 12 kg et 20 ≥12 kg. L’échantillonnage de laPetCO2 se fait par un cathéter 16G de 5 cm fixé sous une narine et la comparaison est établie avec un prélévement artériel. Vingt patients additionnels sont étudiés pendant une anesthésie inhalatoire. LaPetCO2 est mesurée à la fois à l’extrémité proximate du raccord coudé et par une canule de 5 cm insérée a travers le raccord. (Un échantillon de sang artériel est prélevé simultanément. La différence artério-téléexpiratoire (Pa-ET) est comparée au niveau des deux sites. A l’unité des soins postopératoires, la corrélation entrePetCO2 et PaCO2 est bonne et indépendante du poids: Pa-EtCO2 = −0,6 ±3,6 (< 12 kg) et −1,1 ±2,8 mm Hg (≥12 kg). Pendant l’anesthésie au masque, la corrélation a été meilleure entrePetCO2 et PaCO2 quand laPetCO2 est prélevée par la canule: Pa-EtCO2 de 3,5 ±4,8 mm Hg (canule), 8,6 ±4,5 (raccord) (P < 0,05). Ces résultats suggèrent que le monitorage du CO2 téléexpiratoire est utile et liable pour évaluer la suffisance de la ventilation chez des enfants pesant de 5,2 à 35 kg.
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Campbell, F.A., McLeod, M.E., Bissonnette, B. et al. End-tidal carbon dioxide measurement in infants and children during and after general anaesthesia. Can J Anaesth 41, 107–110 (1994). https://doi.org/10.1007/BF03009801
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DOI: https://doi.org/10.1007/BF03009801