Open AccessAssessing Agreement of Transcutaneous Carbon Dioxide Monitoring and Blood Gas Analysis in a Neonatal Population
Author(s) -
Mia Kahvo,
Ajit Mahaveer,
Ranganath Ranganna
Publication year - 2021
Publication title -
open journal of pediatrics and neonatology
Language(s) - English
Resource type - Journals
ISSN - 2769-6200
DOI - 10.53996/2769-6200.ojpn.1000104
Subject(s) - concordance , medicine , neonatal intensive care unit , limits of agreement , carbon dioxide , observational study , concordance correlation coefficient , population , prospective cohort study , blood gas analysis , tertiary care , anesthesia , pediatrics , emergency medicine , surgery , nuclear medicine , statistics , mathematics , environmental health , ecology , biology
Objective: To assess agreement between transcutaneous carbon dioxide (TcCO2) monitoring and blood gas analysis in neonates. Study Design: This was a prospective observational study performed in a tertiary neonatal intensive care unit. 19 infants with a mean postmenstrual age of 35+3 weeks were included. Agreement was assessed by Bland-Altman analysis and concordance correlation coefficient. End-user feedback was collected from staff and infants were assessed for evidence of skin damage. Results: Overall bias from 698 paired samples was -0.30 (SD 1.21, p<0.0001) with good concordance (CCC 0.80). 69% (95% CI 65%-72%, p=0.0003) of samples fell within the predefined clinically acceptable difference of 1kPa. Agreement was more favorable for non-invasively ventilated infants (bias -0.11, CCC 0.91). Staff feedback was positive, and no infants suffered skin damage. Conclusion: TcCO2 monitoring is a reliable assessment tool for both invasively and non-invasively ventilated neonates. It can be used as an adjunct to blood gas analysis, reducing the frequency of invasive blood tests.