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Abstract
BACKGROUND: Infants with hypoxic-ischemic encephalopathy are often treated with therapeutic hypothermia and high-frequency ventilation. Fluctuations in PaCO2 during therapeutic hypothermia are associated with poor neurodevelopmental outcomes. Transcutaneous CO2 monitors offer a noninvasive estimate of PaCO2 represented by transcutaneously measured partial pressure of carbon dioxide (PtcCO2). We aimed to assess the precision between PtcCO2 and PaCO2 values in neonates undergoing therapeutic hypothermia.
METHODS: This was a retrospective chart review of 10 neonates who underwent therapeutic hypothermia requiring respiratory support over 2 y. A range of 2–27 simultaneous PtcCO2 and PaCO2 pairs of measurements per neonate were analyzed via linear mixed models and a Bland-Altman plot for multiple observations per neonate.
RESULTS: A linear mixed-effect model demonstrated that PtcCO2 and PaCO2 (controlling for sex) were similar. The 95% CI of the mean difference ranged from −2.3 to 5.7 mm Hg (P = .41). However, precision was poor as the PtcCO2 ranged from > 18 mm Hg to < 13 mm Hg than PaCO2 values for 95% of observations.
CONCLUSIONS: The neonates’ PtcCO2 was as much as 18 mm Hg higher to 13 mm Hg lower than the PaCO2 95% of the time. Transcutaneous CO2 monitoring may not be a good trending tool, nor is it appropriate for estimating PaCO2 in patients undergoing therapeutic hypothermia.
Footnotes
- Correspondence: Gerald S Zavorsky PhD RPFT, Department of Physiology and Membrane Biology, 4303 Tupper Hall, One Shields Ave, Davis, CA 95616. E-mail: gszavorsky{at}ucdavis.edu
The authors have disclosed no conflicts of interest.
A version of this manuscript were presented by Mr Smith at AARC Congress 2021 LIVE! held virtually December 1, 3, 7, and 9, 2021 and by Dr Garlapati at the Western Medical Research Conference, held virtually January 2021.
- Copyright © 2024 by Daedalus Enterprises
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