Noninvasive Monitoring of Carbon Dioxide in Infants and Children With Congenital Heart Disease: End-Tidal Versus Transcutaneous Techniques

Abstract

End-tidal CO ₂ (ET ^CO ₂ ) monitoring and transcutaneous (TC) CO ₂ monitoring were prospectively compared in 53 patients, 1 month to 16 years of age, with congenital heart disease (CHD). There were 32 patients with cyanotic CHD and 21 with acyanotic CHD. The TC-Pa CO ₂ difference was 2 ± 1 mm Hg and the ET-Pa CO ₂ difference was 5 ± 3 mm Hg ( P < .0001). The TC-Pa CO ₂ difference was≤2 mm Hg in 30 of 53 patients and≤5 mm Hg in 53 of 53 patients. The ETPa CO ₂ difference was≤2 mm Hg in 9 of 53 patients and≤5 mm Hg in 30 of 53 patients ( P < .001). No variation in the TC-Pa CO ₂ difference was noted based on the type of CHD (acyanotic vs cyanotic) or age. The ET-Pa CO ₂ difference was greater in patients with cyanotic versus acyanotic CHD (7 ± 3 mm Hg vs 4 ± 2 mm Hg, P < .0001) and in patients≤1 year of age versus patients ≥1 year of age (6 ± 3 mm Hg vs 4 ± 2, P = .008). In infants and children with CHD, TC monitoring provides a more accurate estimation of Pa CO ₂ than ET monitoring.

Keywords

transcutaneous carbon dioxide monitoring end-tidal carbon dioxide monitoring congenital heart disease non invasive monitoring

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