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Transcutaneous carbon dioxide monitoring in infants and children
Author(s) -
TOBIAS JOSEPH D.
Publication year - 2009
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2009.02930.x
Subject(s) - medicine , ventilation (architecture) , intensive care medicine , carbon dioxide , metabolic acidosis , respiratory monitoring , respiratory acidosis , diabetic ketoacidosis , apnea , airway , pediatrics , anesthesia , acidosis , respiratory system , mechanical engineering , ecology , insulin , engineering , biology
Summary Objective: To review the technology required for and the applications of transcutaneous carbon dioxide (TC‐CO 2 ) monitoring in infants and children. Data source: A computerized, bibliographic search regarding the applications of transcutaneous carbon dioxide (TC‐CO 2 ) monitoring in infants and children. Results: Although the direct measurement of P a CO 2 remains the gold standard, it provides only a single measurement of what is often a rapidly changing and evolving clinical picture. Given these concerns, there remains a clinical need for a means to continuously monitor P a CO 2 without the need for repeated blood gas analysis. Although initially introduced into the neonatal intensive care unit; with improvements in the technology, TC‐CO 2 monitoring can now be used in infants, children and even adults. When compared with end‐tidal carbon dioxide (ET‐CO 2 ) monitoring techniques, TC‐CO 2 monitoring has been shown to be equally as accurate in patients with normal respiratory function and more accurate in patients with shunt or ventilation–perfusion inequalities. TC‐CO 2 monitoring can be applied in situations that generally preclude ET‐CO 2 monitoring such as high frequency ventilation, apnea testing, and noninvasive ventilation. TC‐CO 2 monitoring has also been used in spontaneously breathing children with airway and respiratory issues such as croup and status asthmaticus as well as to monitor metabolic status during treatment of acidosis related to diabetic ketoacidosis. Conclusions: Transcutaneous carbon dioxide monitoring may be a useful adjunct in various clinical scenarios in infants and children. It should be viewed as a complimentary technology and may be used in combination with ET‐CO 2 monitoring.