Measurement of gastric-to-end-tidal carbon dioxide difference in neonates requiring intensive care
Objective: Gastric-arterial partial CO(2) pressure gap (P(g-)(a)CO(2) gap) measured by gastric tonometry may detect the disturbance of splanchnic perfusion. As in the neonatal age it is very difficult to follow up the circulatory condition with frequent acid-base examinations, we wanted to compare t...
Elmentve itt :
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2012
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| Sorozat: | JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
25 No. 9 |
| Tárgyszavak: | |
| doi: | 10.3109/14767058.2012.663833 |
| mtmt: | 1986174 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/30171 |
| Tartalmi kivonat: | Objective: Gastric-arterial partial CO(2) pressure gap (P(g-)(a)CO(2) gap) measured by gastric tonometry may detect the disturbance of splanchnic perfusion. As in the neonatal age it is very difficult to follow up the circulatory condition with frequent acid-base examinations, we wanted to compare the P(g-)(a)CO(2) gap with an alternative gap of P(g)CO(2) - end-tidal carbon dioxide (P(g)(-)(ET)CO(2) gap). Methods: A prospective study was performed on ventilated neonates requiring intensive therapy (n = 44, weight: 1813 +/- 977 g). P(ET)CO(2) and P(g)CO(2) were measured with a side stream capnograph. We applied a newly developed gastric tonometric probe. Patients were divided into two groups: Group 1 of patients in stable condition (n = 35) and Group 2 of patients with severe condition (i.e. Clinical Risk Index for Babies [CRIB] score higher than 10; n = 9). For main statistical analysis a mixed model repeated measurements ANOVA, Bland-Altman analysis were applied. Results: P(g)(-)(ET)CO(2) gap was higher than P(g-)(a)CO(2) gap (11.40 +/- 7.79 versus 3.63 +/- 7.98 mmHg, p < 0.01). Both gaps were higher in Group 2 (8.71 +/- 10.89 and 18.27 +/- 10.49 versus 2.53 +/- 6.78 and 9.92 +/- 6.22 mmHg, p < 0.01 and p < 0.05). Bland-Altman analysis of the two gaps showed an acceptable correspondence. Conclusions: P(g)(-)(ET)CO(2) gap may be used as a method for continuous estimation of splanchnic perfusion and a prognostic index also in critically ill neonates. However, the P(g-)(a)CO(2) gap should not be abandoned. |
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| Terjedelem/Fizikai jellemzők: | 1791-1795 |
| ISSN: | 1476-7058 |