End-tidal CO2(ETCO2) monitoring and transcutaneous (TC) CO2monitoring 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-PaCO2difference was 2 ± 1 mm Hg and the ET-PaCO2difference was 5 ± 3 mm Hg (P< .0001). The TC-PaCO2difference was≤2 mm Hg in 30 of 53 patients and≤5 mm Hg in 53 of 53 patients. The ETPaCO2difference 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-PaCO2difference was noted based on the type of CHD (acyanotic vs cyanotic) or age. The ET-PaCO2difference 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 PaCO2than ET monitoring.
Pansard JL, Cholley B, Devilliers C, et al.Variation in the arterial to end-tidal CO2 tension differences during anesthesia in the “kidney rest” lateral decubitus position. Anesth Analg. 1992;75:506-510.
2.
Grenier B, Verchere E, Meslie A, et al.Capnography monitoring during neurosurgery: Reliability in relation to various intraoperative positions. Anesthesiology. 199;88:43-48.
3.
Short JA, Paris ST, Booker BD, et al.Arterial to end-tidal carbon dioxide tension difference in children with congenital heart disease. Br J Anaesth. 2001;86:349-353.
4.
Burrows FA. Physiologic dead space, venous admixture and the arterial to end-tidal carbon dioxide difference in infants and children undergoing cardiac surgery. Anesthesiology. 1989;70:219-225.
5.
Badgwell JM, Heavener JE, May WS, et al.End-tidal pCO2 monitoring in infants and children ventilated with either a partial rebreathing or non-rebreathing circuit. Anesthesiology. 1987;66:405-410.
6.
Badgwell JM, McLeod ME, Lerman J, et al.End-tidal pCO2 measurements sampled at the distal and proximal ends of the endotracheal tube in infants and children. Anesth Analg. 1987;66:959-964.
7.
Tremper KK, Shoemaker WC, Shippy CR, Nolan LS. Transcutaneous pCO2 monitoring on adult patients in the ICU and the operating room. Crit Care Med. 1981;9:752-755.
8.
Nosovitch MA, Johnson JO, Tobias JD. Noninvasive intraoperative monitoring of carbon dioxide in children: Endtidal versus transcutaneous techniques. Anesth Analg. 2002;12:48-52.
9.
Tobias JD. Noninvasive carbon dioxide monitoring during one-lung ventilation: End-tidal versus transcutaneous techniques. J Cardiothorac Vasc Anesth. 2003;17:306-308.
10.
Tobias JD, Meyer DJ. Non-invasive monitoring of carbon dioxide during respiratory failure in toddlers and infants: End-tidal versus transcutaneous carbon dioxide. Anesth Analg. 1997;85:55-58.
11.
Berkenbosch JW, Lam J, Burd RS, Tobias JD. Noninvasive monitoring of carbon dioxide during mechanical ventilation in older children: End-tidal versus transcutaneous techniques. Anesth Analg. 2001;92:1427-1431.
12.
Tobias JD, Wilson WR Jr, Meyer DJ. Transcutaneous monitoring of carbon dioxide tension after cardiothoracic surgery in infants and children. Anesth Analg. 1999;88:531-534.
13.
Cassady G.Transcutaneous monitoring in the newborn infant. J Pediatr. 1983;103:837-848.
