Agreement Between Arterial Carbon Dioxide Levels With End-Tidal Carbon Dioxide Levels and Associated Factors in Children Hospitalized With Traumatic Brain Injury

Key Points Question Is end-tidal carbon dioxide (EtCO 2 ) a reliable surrogate for partial pressure of carbon dioxide, arterial (Pa co 2 ) in children admitted to the intensive care unit with traumatic brain injury? Findings In this secondary analysis of a prospective cohort study that included 445 paired Pa co 2 -EtCO 2 values from 137 patients, only 42.0% of Pa co 2 values were within 0 to 5 mm Hg of paired EtCO 2 values. Development of pediatric acute respiratory distress syndrome within 24 hours after admission was associated with significantly lower likelihood of Pa co 2 -EtCO 2 agreement than was no development of pediatric acute respiratory distress syndrome. Meaning This study suggests that EtCO 2 values are not a reliable substitute for Pa co 2 values during the first 24 hours after pediatric traumatic brain injury, especially in the presence of pediatric acute respiratory distress syndrome.