PT - JOURNAL ARTICLE AU - Aurélien Frérou AU - Adel Maamar AU - Sonia Rafi AU - Claire Lhommet AU - Pierre Phelouzat AU - Emmanuel Pontis AU - Florian Reizine AU - Mathieu Lesouhaitier AU - Christophe Camus AU - Yves Le Tulzo AU - Jean-Marc Tadié AU - Arnaud Gacouin TI - Monitoring Transcutaneously Measured Partial Pressure of CO<sub>2</sub> During Intubation in Critically Ill Subjects AID - 10.4187/respcare.08009 DP - 2021 Jun 01 TA - Respiratory Care PG - 1004--1015 VI - 66 IP - 6 4099 - http://rc.rcjournal.com/content/66/6/1004.short 4100 - http://rc.rcjournal.com/content/66/6/1004.full AB - BACKGROUND: The risk for severe hypoxemia during endotracheal intubation is a major concern in the ICU, but little attention has been paid to CO2 variability. The objective of this study was to assess transcutaneously measured partial pressure of CO2 ( ) throughout intubation in subjects in the ICU who received standard oxygen therapy, high-flow nasal cannula oxygen therapy, or noninvasive ventilation for preoxygenation. We hypothesized that the 3 methods differ in terms of ventilation and CO2 removal.METHODS: In this single-center, prospective, observational study, we recorded from preoxygenation to 3 h after the initiation of mechanical ventilation among subjects requiring endotracheal intubation. Subjects were sorted into 3 groups according to the preoxygenation method. We then assessed the link between variability and the development of postintubation hypotension.RESULTS: A total of 202 subjects were included in the study. The values recorded at endotracheal intubation, at the initiation of mechanical ventilation, and after 30 min and 1 h of mechanical ventilation were significantly higher than those recorded during preoxygenation (P &lt; .05). variability differed significantly according to the preoxygenation method (P &lt; .001, linear mixed model). A decrease in by &gt; 5 mm Hg within 30 min after the start of mechanical ventilation was independently associated with postintubation hypotension (odds ratio = 2.14 [95% CI 1.03–4.44], P = .039) after adjustments for age, Simplified Acute Physiology Score II, COPD, cardiac comorbidity, the use of propofol for anesthetic induction, and minute ventilation at the start of mechanical ventilation.CONCLUSIONS: variability during intubation is significant and differs with the method of preoxygenation. A decrease in after the beginning of mechanical ventilation was associated with postintubation hypotension. (ClinicalTrials.gov registration NCT0388430.)