Continuous integrated distal capnography in infants ventilated with high frequency ventilation.

Amir Kugelman, Arieh Riskin, Irit Shoris, Michal Ronen, Iris Shalev Stein, David Bader

B&R Faculty of Medicine, Department of Neonatology, Bnai Zion Med. Center, Technion, Haifa, Israel. dramir@netvision.net.il

Pediatric pulmonology 2012 Sep

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To assess within a feasibility study the correlation, agreement, and trending of continuous integrated distal capnography (dCap) with PaCO(2) in infants on HFV. 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 cmH(2) O, FiO(2) : 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 PaCO(2) . Integrated time-window analysis of the data was performed retrospectively on data collected prospectively. Analysis included 195 measurements. The correlation of dCap with PaCO(2) (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 PaCO(2) for consecutive measurements within each patient were adequately correlated (r = 0.65, P < 0.0001). Continuous integrated dCap is feasible in premature infants ventilated with HFV and can be helpful for trends and alarm for unsafe levels of PaCO(2) . Copyright © 2012 Wiley Periodicals, Inc.

Citation

Amir Kugelman, Arieh Riskin, Irit Shoris, Michal Ronen, Iris Shalev Stein, David Bader. Continuous integrated distal capnography in infants ventilated with high frequency ventilation. Pediatric pulmonology. 2012 Sep;47(9):876-83