Discrepancies between transcutaneous and end-tidal carbon dioxide monitoring in the critically ill neonate with respiratory distress syndrome

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Abstract
Paco2 transcutaneous Pco2 (Ptcco2). and end-tidal PcO2 (PetcO2) measurements were studied in 12 critically ill neonates. Ptcco2 was measured using a combination CO2/O2 sensor during the routine care of these patients. End-tidal sidestream sampling was performed during blood gas measurement as dictated by the patient's clinical condition. There was a linear correlation between Ptcco2 and Paco2 (n = 51. r = .71, slope = 0.90). Petco2 and Paco2 did not correlate as well (n = 51, r = .52, slope = 0.42). Acidosis negatively affected the correlation between Ptcco2 and Paco2 When pH was >7.30, r = .75 and slope = 1.28 (n = 38), whereas when pH was < 7.30, r = .62 and slope = 0.73 (n = 13). The presence or absence of a metabolic acidosis did not have a significant effect on the slopes obtained. Ptcco2 monitoring using combined sensors is a useful and practical means of monitoring in the neonatal ICU although acidosis affects the ability to correlate transcutaneous and arterial values. End-tidal sidestream measurements are not as clinically useful because they vary due to different ventilation/perfusion relationships in the sick neonate.

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