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Are carbon dioxide detectors useful in neonates?

¹ Division of Neonatology, National Maternity Hospital, Dublin, Ireland
² Department of Respiratory Care, Rainbow Babies & Children’s Hospital, Cleveland, Ohio, USA

Correspondence to:
Correspondence to:
Dr Molloy
National Maternity Hospital, Holles St, Dublin 2, Ireland; elesean{at}hotmail.com

ABSTRACT
Maintenance of neonatal normocarbia may prevent chronic lung disease and periventricular leucomalacia, but this requires frequent arterial sampling, which has risks. Alternative methods for measuring CO₂ are therefore desirable. These include end tidal CO₂, capillary sampling, and transcutaneous measurements. CO₂ detectors have also proved effective and rapid indicators of endotracheal intubation. However, this method relies on the presence of exhaled CO₂, which may be reduced in certain situations, such as cardiopulmonary arrest. Colorimetric CO₂ detectors are therefore valuable adjuncts for airway management, especially during resuscitation, but PaCO₂ is still the best measure of CO₂ in neonatal practice.

Abbreviations: PaCO₂, arterial partial pressure of carbon dioxide; ETCO₂, end-tidal CO₂; ETT, endotracheal tube; TcPCO₂, transcutaneous carbon dioxide; ECMO, extracorporeal membrane oxygenation

Keywords: extracorporeal membrane oxygenation; endotracheal intubation; hypocarbia; resuscitation