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Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible

BACKGROUND: Transcutaneous (TC) measurement of Pco(2) (TC Pco(2)) is a well-established method to monitor assisted ventilation in neonatal intensive care, but its use in the operating room is limited, and the data regarding its performance during general anesthesia of the newborn are lacking. The ai...

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Autores principales: Karlsson, Victoria, Sporre, Bengt, Ågren, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017270/
https://www.ncbi.nlm.nih.gov/pubmed/27464976
http://dx.doi.org/10.1213/ANE.0000000000001462
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author Karlsson, Victoria
Sporre, Bengt
Ågren, Johan
author_facet Karlsson, Victoria
Sporre, Bengt
Ågren, Johan
author_sort Karlsson, Victoria
collection PubMed
description BACKGROUND: Transcutaneous (TC) measurement of Pco(2) (TC Pco(2)) is a well-established method to monitor assisted ventilation in neonatal intensive care, but its use in the operating room is limited, and the data regarding its performance during general anesthesia of the newborn are lacking. The aim of this study is to evaluate the performance of continuous TC Pco(2) monitoring during general anesthesia in newborn infants. METHODS: Infants (n = 25) with a gestational age of 23 to 41 weeks and a birth weight of 548 to 4114 g were prospectively enrolled. During general anesthesia and surgery, TC Pco(2) was measured continuously and recorded at 1-minute intervals. Five-minute mean values were compared with simultaneously obtained blood gas (BG) analyses of Pco(2). Only the first paired TC and BG samples were used in this analysis. We defined precision as 2.1 times the standard deviation of the difference of the 2 samples. P < .01 was considered statistically significant. RESULTS: We obtained samples from 25 infants. The difference between TC and BG was 0.3 ± 0.7 kPa (mean ± standard deviation) giving a precision of 1.47 kPa. Nineteen of twenty-five (76%) sample pairs displayed a difference of <1 kPa (99% confidence interval, 48%–92%, P = .016). The difference in paired samples was similar for different gestational and postnatal ages and did not appear to be affected by electrocautery. CONCLUSIONS: In this small study, we did not demonstrate that TC CO(2) monitoring was accurate at P < .01. This partly reflects the small size of the study, resulting in wide 99% confidence bounds.
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spelling pubmed-50172702016-09-26 Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible Karlsson, Victoria Sporre, Bengt Ågren, Johan Anesth Analg Pediatric Anesthesiology BACKGROUND: Transcutaneous (TC) measurement of Pco(2) (TC Pco(2)) is a well-established method to monitor assisted ventilation in neonatal intensive care, but its use in the operating room is limited, and the data regarding its performance during general anesthesia of the newborn are lacking. The aim of this study is to evaluate the performance of continuous TC Pco(2) monitoring during general anesthesia in newborn infants. METHODS: Infants (n = 25) with a gestational age of 23 to 41 weeks and a birth weight of 548 to 4114 g were prospectively enrolled. During general anesthesia and surgery, TC Pco(2) was measured continuously and recorded at 1-minute intervals. Five-minute mean values were compared with simultaneously obtained blood gas (BG) analyses of Pco(2). Only the first paired TC and BG samples were used in this analysis. We defined precision as 2.1 times the standard deviation of the difference of the 2 samples. P < .01 was considered statistically significant. RESULTS: We obtained samples from 25 infants. The difference between TC and BG was 0.3 ± 0.7 kPa (mean ± standard deviation) giving a precision of 1.47 kPa. Nineteen of twenty-five (76%) sample pairs displayed a difference of <1 kPa (99% confidence interval, 48%–92%, P = .016). The difference in paired samples was similar for different gestational and postnatal ages and did not appear to be affected by electrocautery. CONCLUSIONS: In this small study, we did not demonstrate that TC CO(2) monitoring was accurate at P < .01. This partly reflects the small size of the study, resulting in wide 99% confidence bounds. Lippincott Williams & Wilkins 2016-10 2016-09-19 /pmc/articles/PMC5017270/ /pubmed/27464976 http://dx.doi.org/10.1213/ANE.0000000000001462 Text en Copyright © 2016 International Anesthesia Research Society. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Pediatric Anesthesiology
Karlsson, Victoria
Sporre, Bengt
Ågren, Johan
Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible
title Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible
title_full Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible
title_fullStr Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible
title_full_unstemmed Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible
title_short Transcutaneous Pco(2) Monitoring in Newborn Infants During General Anesthesia Is Technically Feasible
title_sort transcutaneous pco(2) monitoring in newborn infants during general anesthesia is technically feasible
topic Pediatric Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017270/
https://www.ncbi.nlm.nih.gov/pubmed/27464976
http://dx.doi.org/10.1213/ANE.0000000000001462
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