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A new paediatric metabolic monitor

  • Neonatal and Pediatric Intensive Care
  • Published:
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Abstract

Objective

A paediatric option for the measurement of\(\dot VO_2\) and\(\dot VCO_2\) (20 to 150 ml/min) has recently been introduced for the adult Deltatrac metabolic monitor (Datex Instrumentarium, Finland) to use in ventilated and spontaneously breathing children. This paper describes a laboratory validation of the paediatric option for ventilated children with regard to the influence of respiratory variables.

Design

Respiratory variables were varied within the following ranges: FIO2 0.21–0.8,\(\overline {FEO_2 }\) (DFO2) 0.01–0.05,\(\overline {FECO_2 } 0.01 - 0.05,\dot V_E 300 - 6000ml/\min\), VT 8–300 ml, RR 10–50/min, Paw 10–60 mbar, relative humidity 10% and 60%, and resulted in 107 test situations.

Setting

Gas exchange was simulated by injection of nitrogen and CO2 at a RQ close to 1.

Patients or participants

Different situations of paediatric patients ventilated in controlled mode were simulated on a gas injection model.

Interventions

Respiratory and metabolic variables were varied independently to result in a range of 8 to 210 ml/min of\(\dot VO_2\) and\(\dot VCO_2\).

Measurements and results

Reference measurements were carried out by mass spectrometry and wet gas spirometry. The mean\(\dot VCO_2\) difference for all tests ranging from 20 ml/min to 210 ml/min was −2.4% (2SD=±12%). The respective\(\dot VO_2\) difference was −3.2% (2SD=±23%). Measurement agreement for\(\dot VO_2\) in neonatal respirator treatment (20–50 ml/min) compared to older children (50–210 ml/min) showed a mean difference of −3.9% (2SD=±26%) versus −2.8% (2SD=±20%). The respective differences for\(\dot VCO_2\) were −7.1% (2SD=±7%) versus +0.4% (2SD=±10%). The mean difference for\(\dot VO_2\) as well as\(\dot VCO_2\) indicated a high systematic agreement of both methods. The variability (±2SD) in\(\dot VCO_2\) measurement is acceptable for all applications. The overall variability in\(\dot VO_2\) measurement (2SD=±23%) can be reduced by exclusion of all tests with a\({FECO_2 }\) and DFO2 below 0.03. This results in a mean difference of −3.2% (2SD=±13.7%).

Conclusion

Within this limitation the paediatric measurement option seems to introduce a valuable method for clinical application in paediatric intensive care medicine.

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Weyland, W., Weyland, A., Fritz, U. et al. A new paediatric metabolic monitor. Intensive Care Med 20, 51–57 (1994). https://doi.org/10.1007/BF02425058

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  • DOI: https://doi.org/10.1007/BF02425058

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