Reliability of cerebral oximeter in non-invasive diagnosis and follow-up of hypercapnia

In this study, aimed to evaluate the sensitivity and specificity of cerebral oximetry and EtCO2 values in non-invasive diagnosis and monitoring of hypercapnia. This study enrolled pediatric patients admitted to and mechanically ventilated at the Pediatric Intensive Care Unit of Gaziantep University Faculty of Medicine Hospital between January 2014 and January 2015. Patients’ age, gender, diagnosis, ventilatory parameters, a measured of the mean end-tidal carbon dioxide value stream method, and the simultaneously monitored arterial blood gas PaCO2 level and near infrared spectroscopy device (NIRS) measurements were recorded. The mean age of patients was 61 months (min 4-max 193), and there were 8 (53.4%) female and 7 (46.6%) male subjects. A significant correlation was found between PCO2 and NIRS, PCO2 and EtCO2 (r = 0.571, p

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1. Fan JL, Burgees KR, Basnyat R, Thomas KN, Ogoh S, Ainslie PN. Influence of indomethacin on ventilatory and cerebrovascular responsiveness to CO2 and breathing stability: the influence of pCO2 gradients. Am J Physiol Regul Integr Comp Physiol 2010; 298: 1648-1658.
2. Hagen EW, Sadek-Badawi M, Carlton DP, Palta M. Permissive hypercapnia and risk for brain injury and developmental impairment. Pediatrics 2008; 122: e583-e589.
3. Vorstrup S, Andersen A, Juhler M, Brun B, Boysen G. Hemodilution increases cerebral blood flow in acute ischemic stroke. Stroke 1989; 20: 884-889. 4. Kacmarek RM, Hickling KG. Permissive hypercapnia. Respir Care 1993; 38: 373-387.
5. Doerr CH, Gajic O, Berrios JC, et al. Hypercapnic acidosis impairs plasma membrane wound releasing in ventilator-injured lungs. Am J Respir Crit Care Med 2005; 171: 1371-1377.
6. Feihl F, Perret C. Permissive hypercapnia. How permissive should we be? Am J Respir Crit Care Med 1994; 150: 1722-1737.
7. Tateyama T, Asada M, Suzuki H, et al. Effects of 10% carbon dioxide on regional myocardial tissue oxygen tension and myocardial metabolism. Masui 1994; 43: 59-63.
8. Wu CH, Chou HC, Hsieh WS, et al. Good estimation of arterial carbon dioxide monitoring in neonatal intensive care unit. Pediatr Pulmonol 2003; 35: 292-295.
9. Drayna PG, Abramo TJ, Estrada C. Near infrared spectroscopy in the critical setting. Ped Emerg Care 2011; 27: 432-439.
10. Grahanayem NS, Wernovsky G, Hoffman GM. Near infrared spectroscopy as a hemodynamic monitor in critical illness. Pediatr Crit Care Med 2011; 12: 27-32. 11. Orliaguet GA. Cerebral monitoring in children. Paediatr Anaesth 2004; 14: 407-411.
12. Ward KR, Yealy DM. End-tidal carbon dioxide monitoring in emergency medicine, Part 2: Clinical applications. Acad Emerg Med 1998; 5: 637-646.
13. Bhende MS. Capnography in the pediatric emergency department. Pediatr Emerg Care 1999; 15: 64-69.
14. Rozycki HJ, Sysyn GD, Marshall MK, Malloy R, Wiswell TE. Mainstream end-tidal carbon dioxide monitoring in the neonatal intensive care unit. Pediatrics 1998; 101: 648-653.
15. Bhat YR, Abhisbek N. Mainstream end-tidal carbon dioxide moniyoring in ventilated neonates. Singapore Med J 2008; 49: 199-203.
16. Tingay DG, Stewart MJ, Morley CJ. Monitoring of end tidal carbon dioxide and transcutaneous carbon dioxide during neonatal transport. Arch Dis Child Fetal Neonatal Ed 2005; 90: 523-526.
17. Mcdonalds MJ, Montgomery VL, Cerrito PB, Parrish CJ, Boland KA, Sullivan JE. Comparison of end-tidal CO2 and Paco2 in children receiving mechanical ventilation. Pediatr Crit Care Med 2002; 3: 244-249.
18. Razi E, Moosavi GA, Omidi K, Saebi AK, Razi A. Correlation of end-tidal carbon dioxide with arterial carbon dioxide in mechanically ventilated patients. Arch Trauma Res 2012; 1: 58-62.
19. Mehta H, Kashyap R, Trivedi S. Correlation of end tidal and arterial carbon dioxide levels in critically Ill neonates and children. Indian J Crit Care Med 2014; 18: 348-353.
20. Bhat YR, Abhisnek N. Mainstream and-tidal carbondioxide monitoring in ventilated neonates. Singapore Med J 2008; 49: 199-203.
21. De Waal EEC, Jaap W, Kruitwagen CL, Kalkman CJ. The effects of low-pressure carbon dioxide pneumoperitoneum on cerebral oxygenation and cerebral blood volume in children. Anesth Analg 2002; 94: 500-505.
22. Ito H, Ibaraki M, Kanno I, et al. Changes in the arterial fraction of cerebral blood volume during hypercapnia and hypocapnia measured by positron emission tomography. J Cereb Blood Flow Metab 2005; 25: 852-857.
23. Tisdall M, Taylor C, Tachtsidis I, et al. The effect on cerebral tissue oxygenation index of changes in the concentrations of inspired oxygen and end-tidal carbon dioxide in healthy adult volunteers. Anesth Analg 2009; 109: 906-913.
24. Quarti A, Nardone S, Manfrini F, et al. Effect of the adjunct of carbon dioxide during cardiopulmonary bypass on cerebral oxygenation. Perfusion 2012; 28: 152-155.