Transcutaneous PCO₂ monitoring in infants hospitalized with viral bronchiolitis

Our objective was to assess within a feasibility study the correlation and agreement of transcutaneous carbon dioxide (PtcCO₂) monitoring with venous carbon dioxide (PvCO₂) in infants with bronchiolitis in the emergency room (ER) and pediatric department. Sixty infants (aged 3.6 ± 3.3 months) admitted to our ER with bronchiolitis were included. PtcCO₂ measurements (SenTec Digital Monitoring System) collected prospectively were compared with simultaneous PvCO₂ drawn for patient care. Analysis included 100 measurements. The correlation of PtcCO₂ and PvCO₂ (r = 0.71, p < 0.001) was good, and the agreement (mean difference ± standard deviation of the differences 1.9 ± 7.0 mmHg) was adequate; average PtcCO₂ was slightly lower than PvCO₂. Changes in PtcCO₂ and PvCO₂ for consecutive measurements within each patient correlated (r = 0.41, p < 0.01). The level of PtcCO₂ correlated with disease severity clinical score (p < 0.001). Conclusions: PtcCO₂ monitoring was feasible in the ER and pediatric department and was found to have a good correlation and adequate agreement with PvCO₂ in infants with bronchiolitis. Because the standard deviation of the differences was relatively high, though comparable to the literature, we suggest that PtcCO₂ should not replace blood gas but rather serve as a complementary tool for trending and for real-time continuous assessment of the CO₂ levels.