BACKGROUND: Although accurate quantification of oxygen consumption (V̇O2) and carbon dioxide elimination (V̇CO2) provides important insights into a patient's nutritional and hemodynamic status, few devices exist to accurately measure these parameters in children. Therefore, we assessed the accuracy and agreement of 2 devices currently on the market using a pediatric in vitro model of gas exchange.
METHODS: We utilized a Huszczuk simulation model, which simulates oxygen consumption and carbon dioxide production using gas dilution, to examine the accuracy of two FDA-cleared respiratory modules (E-COVX and E-sCAiOVX-00). V̇O2 and V̇CO2 were set at 20, 40, 60, and 100 mL/min, ranges typical for infant and pediatric patients. Bland-Altman analysis was used to calculate the bias and limits of agreement of each device relative to simulated values for V̇O2 and V̇CO2.
RESULTS: The E-COVX mean percentage bias (limits of agreement) was −26.3% (−36.1 to −16.6%) and −39.3% (−47.5 to −31.1%) for V̇O2 and V̇CO2, respectively. The mean bias (limits of agreement) for the E-aCAiOVX-00 was −0.5% (−13.3 to 12.3%) and −6.0% (−13.8 to 1.7%) for V̇O2 and V̇CO2, respectively.
CONCLUSIONS: The E-COVX demonstrated bias and limits of agreement that were not clinically acceptable; therefore, application of this module to pediatric patients would not be recommended. The new module, E-sCAiOVX, demonstrated acceptable bias and limits of agreement for the V̇O2 and V̇CO2 in the range 40–100 mL/min (which corresponds to patients in the range of ∼5–16 kg).
- Correspondence: Craig D Smallwood RRT, Division of Critical Care Medicine, Department of Anesthesiology, Pain and Perioperative Medicine, MSICU Office, Bader 634, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115. E-mail: .
The authors have disclosed no conflicts of interest.
- Copyright © 2017 by Daedalus Enterprises