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End tidal carbon dioxide is as reliable as transcutaneous monitoring in ventilated postsurgical neonates


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

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

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

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

Results One hundred thirty-two triplet measures of CO2 were recorded with mean Embedded Image 43.5 (7.3) mm Hg, Embedded Image38.8 (6.4) mm Hg and Embedded Image 43.8 (8.8) mm Hg (p<0.0001 for Embedded Image against Embedded Image; paired t test). The Embedded ImageEmbedded Image bias±2SD was 4.1±9.0 mm Hg and −0.8±13.0 mm Hg for Embedded ImageEmbedded Image. 56.1% of Embedded Image, and 60.6% of Embedded Image values were within ±5 mm Hg of paired Embedded Image.

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

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