Janaillac Marie, Labarinas Sonia, Pfister Riccardo E, Karam Oliver
Neonatal and Pediatric Intensive Care Unit, Geneva University Hospital, Rue Willy Donzé 6, 1250 Geneva, Switzerland.
Crit Care Res Pract. 2016;2016:8041967. doi: 10.1155/2016/8041967. Epub 2016 Jun 8.
Background. In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2) value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2), compared to blood partial pressure of carbon dioxide (pCO2). Methods. Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2 and transcutaneous values and the accuracy between the trends of blood pCO2 and TcpCO2 in all consecutive premature infants born at <33 weeks' gestational age. Results. 248 infants were included (median gestational age: 29 + 5 weeks and median birth weight: 1250 g), providing 1365 pairs of TcpCO2 and blood pCO2 values. Pearson's R correlation between these values was 0.58. The mean bias was -0.93 kPa with a 95% confidence limit of agreement of -4.05 to +2.16 kPa. Correlation between the trends of TcpCO2 and blood pCO2 values was good in only 39.6%. Conclusions. In premature infants, TcpCO2 was poorly correlated to blood pCO2, with a wide limit of agreement. Furthermore, concordance between trends was equally low. We warn about clinical decision-making on TcpCO2 alone when used as continuous monitoring.
背景。对于早产儿而言，将血二氧化碳分压（pCO2）值维持在狭窄范围内对于避免脑损伤很重要。本研究的目的是评估一种非侵入性经皮方法（TcpCO2）与血二氧化碳分压（pCO2）相比的准确性。方法。在一家三级新生儿重症监护病房进行回顾性观察研究。我们分析了所有孕周<33周的连续出生的早产儿的血pCO2与经皮值之间的相关性以及血pCO2和TcpCO2趋势之间的准确性。结果。纳入了248例婴儿（中位孕周：29 + 5周，中位出生体重：1250 g），提供了1365对TcpCO2和血pCO2值。这些值之间的Pearson's R相关性为0.58。平均偏差为-0.93 kPa，95%一致性界限为-4.05至+2.16 kPa。TcpCO2和血pCO2值趋势之间的相关性仅在39.6%的情况下良好。结论。在早产儿中，TcpCO2与血pCO2的相关性较差，一致性界限较宽。此外，趋势之间的一致性同样较低。我们警告在将TcpCO2单独用作连续监测时进行临床决策时要谨慎。
