TY - JOUR
T1 - Continuous integrated distal capnography in infants ventilated with high frequency ventilation
AU - Kugelman, Amir
AU - Riskin, Arieh
AU - Shoris, Irit
AU - Ronen, Michal
AU - Stein, Iris Shalev
AU - Bader, David
PY - 2012/9
Y1 - 2012/9
N2 - Objective To assess within a feasibility study the correlation, agreement, and trending of continuous integrated distal capnography (dCap) with PaCO 2 in infants on HFV. Study design Sixteen premature infants [median (range) gestational age: 26.5 (24.7-34.7) weeks], ventilated with HFV (mean ± SD airway pressure: 8.1 ± 2.1 cmH2O, FiO2: 0.39 ± 0.21) for RDS, intubated with a double-lumen endotracheal-tube and whose data were recorded on a bedside computer participated in the study. Side-stream dCap was measured via the extra-port of a double-lumen endotracheal-tube by a Microstream capnograph, with a specially designed software for HFV and compared with simultaneous PaCO2. Integrated time-window analysis of the data was performed retrospectively on data collected prospectively. Results Analysis included 195 measurements. The correlation of dCap with PaCO2 (r = 0.68, P < 0.0001) and the agreement (bias ± precision: -2.0 ± 10.7 mmHg) were adequate. Area under the ROC curves for dCap to detect high (>60 mmHg) or low (<35 mmHg) PaCO 2 was 0.79 (CI: 0.70-0.89) and 0.87 (CI: 0.73-1.00), respectively; P < 0.0001. Changes in dCap and in PaCO2 for consecutive measurements within each patient were adequately correlated (r = 0.65, P < 0.0001). Conclusions Continuous integrated dCap is feasible in premature infants ventilated with HFV and can be helpful for trends and alarm for unsafe levels of PaCO2.
AB - Objective To assess within a feasibility study the correlation, agreement, and trending of continuous integrated distal capnography (dCap) with PaCO 2 in infants on HFV. Study design Sixteen premature infants [median (range) gestational age: 26.5 (24.7-34.7) weeks], ventilated with HFV (mean ± SD airway pressure: 8.1 ± 2.1 cmH2O, FiO2: 0.39 ± 0.21) for RDS, intubated with a double-lumen endotracheal-tube and whose data were recorded on a bedside computer participated in the study. Side-stream dCap was measured via the extra-port of a double-lumen endotracheal-tube by a Microstream capnograph, with a specially designed software for HFV and compared with simultaneous PaCO2. Integrated time-window analysis of the data was performed retrospectively on data collected prospectively. Results Analysis included 195 measurements. The correlation of dCap with PaCO2 (r = 0.68, P < 0.0001) and the agreement (bias ± precision: -2.0 ± 10.7 mmHg) were adequate. Area under the ROC curves for dCap to detect high (>60 mmHg) or low (<35 mmHg) PaCO 2 was 0.79 (CI: 0.70-0.89) and 0.87 (CI: 0.73-1.00), respectively; P < 0.0001. Changes in dCap and in PaCO2 for consecutive measurements within each patient were adequately correlated (r = 0.65, P < 0.0001). Conclusions Continuous integrated dCap is feasible in premature infants ventilated with HFV and can be helpful for trends and alarm for unsafe levels of PaCO2.
KW - capnography
KW - high frequency ventilation
KW - premature infants
UR - http://www.scopus.com/inward/record.url?scp=84865084667&partnerID=8YFLogxK
U2 - 10.1002/ppul.22524
DO - 10.1002/ppul.22524
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C2 - 22328495
AN - SCOPUS:84865084667
SN - 8755-6863
VL - 47
SP - 876
EP - 883
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
IS - 9
ER -