Noninvasive capnometry monitoring for respiratory status during pediatric seizures

Thomas J. Abramo, Robert A. Wiebe, Susan Scott, Collin S. Goto, Donald D. McIntire

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Objective: To determine the reliability and clinical value of end-tidal CO2 by oral/nasal capnometry for monitoring pediatric patients presenting post ictal or with active seizures. Design: Clinical, prospective, observational study. Setting: University affiliated children's hospital. Interventions: One hundred sixty-six patients (105 patients with active seizures, 61 post ictal patients) had end-tidal CO2 obtained by oral/nasal sidestream capnometry, and respiratory rates, oxygen saturation, and pulse rates recorded every 5 mine until 60 mins had elapsed. End-tidal CO2 values were compared with a capillary PCO2 and clinical observation. Measurements and Main Results: The mean end-tidal CO2 reading was 43.0 ± 11.8 torr [5.7 ± 1.6 kPa] and the mean capillary PCO2 reading was 43.4 ± 11.7 torr [5.7 ± 1.6 kPa]. The correlation between end-tidal CO2 and capillary P(CO2) was significant (r2 = .97; p < .0001). A relative average bias of 0.33 torr (0.04 kPa) with end-tidal CO2 lower than capillary P(CO2) was established with 95% limits of agreement ±4.2 torr (±0.6 kPa). Variability of difference scores was not related to range of mean scores (r2 = .00003), age (r2 = .0004), or respiratory rates (r2 = .0009). End-tidal CO2 (r2 = .22; p < .001) correlated better with respiratory rate changes when compared with oxygen saturation (r2 = .02; p = .01). Conclusions: Dependable end-tidal CO2 values can be obtained in pediatric seizure patients using an oral/nasal cannula capnometry circuit. Continuous end-tidal CO2 monitoring provides the clinician with a reliable assessment of pulmonary status that can assist with decisions to provide ventilatory support.

Original languageEnglish (US)
Pages (from-to)1242-1246
Number of pages5
JournalCritical Care Medicine
Volume25
Issue number7
DOIs
StatePublished - Jul 1997

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Seizures
Respiratory Rate
Pediatrics
Nose
Reading
Stroke
Oxygen
Physiologic Monitoring
Observational Studies
Heart Rate
Observation
Prospective Studies
Lung

Keywords

  • Capillary PCO
  • Emergency department
  • End-tidal CO
  • Oxygen saturation
  • Pediatric
  • Seizures

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Noninvasive capnometry monitoring for respiratory status during pediatric seizures. / Abramo, Thomas J.; Wiebe, Robert A.; Scott, Susan; Goto, Collin S.; McIntire, Donald D.

In: Critical Care Medicine, Vol. 25, No. 7, 07.1997, p. 1242-1246.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine the reliability and clinical value of end-tidal CO2 by oral/nasal capnometry for monitoring pediatric patients presenting post ictal or with active seizures. Design: Clinical, prospective, observational study. Setting: University affiliated children's hospital. Interventions: One hundred sixty-six patients (105 patients with active seizures, 61 post ictal patients) had end-tidal CO2 obtained by oral/nasal sidestream capnometry, and respiratory rates, oxygen saturation, and pulse rates recorded every 5 mine until 60 mins had elapsed. End-tidal CO2 values were compared with a capillary PCO2 and clinical observation. Measurements and Main Results: The mean end-tidal CO2 reading was 43.0 ± 11.8 torr [5.7 ± 1.6 kPa] and the mean capillary PCO2 reading was 43.4 ± 11.7 torr [5.7 ± 1.6 kPa]. The correlation between end-tidal CO2 and capillary P(CO2) was significant (r2 = .97; p < .0001). A relative average bias of 0.33 torr (0.04 kPa) with end-tidal CO2 lower than capillary P(CO2) was established with 95{\%} limits of agreement ±4.2 torr (±0.6 kPa). Variability of difference scores was not related to range of mean scores (r2 = .00003), age (r2 = .0004), or respiratory rates (r2 = .0009). End-tidal CO2 (r2 = .22; p < .001) correlated better with respiratory rate changes when compared with oxygen saturation (r2 = .02; p = .01). Conclusions: Dependable end-tidal CO2 values can be obtained in pediatric seizure patients using an oral/nasal cannula capnometry circuit. Continuous end-tidal CO2 monitoring provides the clinician with a reliable assessment of pulmonary status that can assist with decisions to provide ventilatory support.",
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