Endoscopic intratracheal carbon dioxide measurements during pediatric flexible bronchoscopy

Chang, A. B., Moloney, G. E., Harms, P. J. and Masters, I. B. (2004) Endoscopic intratracheal carbon dioxide measurements during pediatric flexible bronchoscopy. Paediatric Anaesthesia, 14 8: 650-655. doi:10.1111/j.1460-9592.2004.01266.x


Author Chang, A. B.
Moloney, G. E.
Harms, P. J.
Masters, I. B.
Title Endoscopic intratracheal carbon dioxide measurements during pediatric flexible bronchoscopy
Journal name Paediatric Anaesthesia   Check publisher's open access policy
ISSN 1155-5645
Publication date 2004
Sub-type Article (original research)
DOI 10.1111/j.1460-9592.2004.01266.x
Volume 14
Issue 8
Start page 650
End page 655
Total pages 6
Editor E. Sumner
Place of publication Oxford, U.K.
Publisher Blackwell Publishing
Collection year 2004
Language eng
Subject C1
321019 Paediatrics
730110 Respiratory system and diseases (incl. asthma)
Abstract Background: CO2 monitoring is recommended for thoracic telescopic procedures and for spontaneous breathing general anesthesia in children. During flexible bronchoscopy (FB) in children, the various currently available methods of CO2 measurements are limited. The CO2 falls and increases have been reported in FB but it is unknown whether airway lesions predispose to CO2 change. The aim of this study was to describe and validate endoscopic intratracheal CO2 measurements in children undergoing FB under spontaneously breathing GA. Methods: Endtidal CO2 (PECO2) measurements at the start (Start-CO2) and end (End-CO2) of FB on 100 consecutive children were performed using a newly designed endoscopic intratracheal method. To validate the method blood gas sampling was simultaneously performed in 28 children and results analyzed using the Bland and Altman method, intraclass correlation and 95% range for repeatability. Results: End-CO2 and CO2-change (End-CO2 minus Start-CO2) were significantly different in children with airway lesions (CO2 change: no lesion = 3 mmHg, extrathoracic airway lesion = 4.5, intrathoracic airway lesion = 8, P = 0.038). There was no significant difference in Start-CO2 values among the groups. CO2-change in those aged > 12 months was similar to those >12 months. Intratracheal CO2 measurements were comparable with arterial blood values in the Bland and Altman plots. The intraclass correlation was 0.69 and 95% range for repeatability was 3.7-4.17 mmHg. Conclusions: Midtracheal PECO2 provides a useful estimate of PaCO2 for monitoring the respiratory status of children undergoing FB. The presence of airway lesions rather than age is associated with significant increased PCO2 rise.
Keyword Anesthesiology
Pediatrics
Bronchoscopy
Carbon Dioxide
Capnography
Hypercapnia
End-tidal Co2
Fiberoptic Bronchoscopy
Children
Airway
Infants
Mask
Tracheomalacia
Anesthesia
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2005 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 04:25:08 EST