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Noninvasive Monitoring of Carbon Dioxide in Infants and Children With Congenital Heart Disease: End-Tidal Versus Transcutaneous Techniques

University of Missouri School of Medicine, Columbia, MO

Pierantonio Russo, MD

Department of Cardiothoracic Surgery, University of Missouri, Columbia, MO

Joanne Russo, RN

Department of Nursing, University of Missouri, Columbia, MO

Joseph D. Tobias, MD

Department of Child Health and Anesthesiology, University of Missouri, Columbia, MO, Tobiasj{at}health.missouri.edu

End-tidal CO₂ (ET^CO₂) monitoring and transcutaneous (TC) CO₂ monitoring were prospectively compared in 53 patients, 1 month to 16 years of age, with congenital heart disease (CHD). There were 32 patients with cyanotic CHD and 21 with acyanotic CHD. The TC-PaCO₂ difference was 2 ± 1 mm Hg and the ET-PaCO₂ difference was 5 ± 3 mm Hg (P < .0001). The TC-PaCO₂ difference was2 mm Hg in 30 of 53 patients and5 mm Hg in 53 of 53 patients. The ETPaCO₂ difference was2 mm Hg in 9 of 53 patients and5 mm Hg in 30 of 53 patients (P < .001). No variation in the TC-PaCO₂ difference was noted based on the type of CHD (acyanotic vs cyanotic) or age. The ET-PaCO₂ difference was greater in patients with cyanotic versus acyanotic CHD (7 ± 3 mm Hg vs 4 ± 2 mm Hg,P < .0001) and in patients1 year of age versus patients 1 year of age (6 ± 3 mm Hg vs 4 ± 2,P = .008). In infants and children with CHD, TC monitoring provides a more accurate estimation of PaCO₂ than ET monitoring.

Key Words: transcutaneous carbon dioxide monitoring • end-tidal carbon dioxide monitoring • congenital heart disease • non invasive monitoring

Journal of Intensive Care Medicine, Vol. 20, No. 5, 291-295 (2005)
DOI: 10.1177/0885066605278652


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