Article Text

End tidal carbon dioxide is as reliable as transcutaneous monitoring in ventilated postsurgical neonates
  1. David Gerald Tingay1,2,3,
  2. Kwok Sean Mun1,
  3. Elizabeth Jean Perkins1,2
  1. 1Department of Neonatology, Royal Children's Hospital, Melbourne, Victoria, Australia
  2. 2Neonatal Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  3. 3Department of Paediatrics, University of Melbourne, Melbourne, Australia
  1. Correspondence to Dr David Gerald Tingay, Department of Neonatology, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; david.tingay{at}


Objectives To compare the agreement, precision and repeatability of end tidal carbon dioxide (Graphic) and transcutaneous carbon dioxide (Graphic) with partial pressure of arterial CO2 (Graphic) in postoperative neonates.

Patients Fifty mechanically ventilated neonates without lung disease, and with no contraindications for either Graphic or Graphic monitoring.

Interventions Paired Graphic and Graphic values were recorded with three consecutive Graphic measurements within the first 48 h of surgery.

Main outcome measures Graphic, Graphic and Graphic triplets were compared using Bland-Altman plots.

Results One hundred thirty-two triplet measures of CO2 were recorded with mean Graphic 43.5 (7.3) mm Hg, Graphic38.8 (6.4) mm Hg and Graphic 43.8 (8.8) mm Hg (p<0.0001 for Graphic against Graphic; paired t test). The GraphicGraphic bias±2SD was 4.1±9.0 mm Hg and −0.8±13.0 mm Hg for GraphicGraphic. 56.1% of Graphic, and 60.6% of Graphic values were within ±5 mm Hg of paired Graphic.

Conclusions In postoperative neonates, Graphic and Graphic demonstrated a clinically acceptable agreement with Graphic.

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