Evaluating a novel formula for noninvasive estimation of arterial carbon dioxide during post-resuscitation care.

Acta Anaesthesiologica Scandinavica
Raisa RentolaJohanna Hästbacka

Abstract

Controlling arterial carbon dioxide is paramount in mechanically ventilated patients, and an accurate and continuous noninvasive monitoring method would optimize management in dynamic situations. In this study, we validated and further refined formulas for estimating partial pressure of carbon dioxide with respiratory gas and pulse oximetry data in mechanically ventilated cardiac arrest patients. A total of 4741 data sets were collected retrospectively from 233 resuscitated patients undergoing therapeutic hypothermia. The original formula used to analyze the data is PaCO2 -est1 = PETCO2  + k[(PIO2  - PETCO2 ) - PaO2 ]. To achieve better accuracy, we further modified the formula to PaCO2 -est2 = k1 *PETCO2  + k2 *(PIO2  - PETCO2 ) + k3 *(100-SpO2 ). The coefficients were determined by identifying the minimal difference between the measured and calculated arterial carbon dioxide values in a development set. The accuracy of these two methods was compared with the estimation of the partial pressure of carbon dioxide using end-tidal carbon dioxide. With PaCO2 -est1, the mean difference between the partial pressure of carbon dioxide, and the estimated carbon dioxide was 0.08 kPa (SE ±0.003); with PaCO2 -est2 the difference was 0.036 ...Continue Reading

References

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Sep 22, 2018·Journal of Clinical Medicine·Raisa RentolaMarkus B Skrifvars

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