@article {Smallwood475, author = {Craig D Smallwood and John N Kheir and Brian K Walsh and Nilesh M Mehta}, title = {Accuracy of Oxygen Consumption and Carbon Dioxide Elimination Measurements in 2 Breath-by-Breath Devices}, volume = {62}, number = {4}, pages = {475--480}, year = {2017}, doi = {10.4187/respcare.05115}, publisher = {Respiratory Care}, abstract = {BACKGROUND: Although accurate quantification of oxygen consumption (V̇O2) and carbon dioxide elimination (V̇CO2) provides important insights into a patient{\textquoteright}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{\textendash}100 mL/min (which corresponds to patients in the range of \~{}5{\textendash}16 kg).}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/62/4/475}, eprint = {https://rc.rcjournal.com/content/62/4/475.full.pdf}, journal = {Respiratory Care} }