Transcutaneous Carbon Dioxide Monitoring with Reduced-Temperature Probes in Very Low Birth Weight Infants.

Obtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO monitoring using reduced-temperature probes (41°C).  The objective of this study was to assess reliability and safety of tcPCO monitoring at reduced-temperature probe in VLBW infants.  A prospective study was conducted on VLBW infants. tcPCO was monitored for 12 hours. Default skin probe temperature was adjusted at 41°C. Blood gases were done as clinically indicated. Arterial partial pressure of CO (PaCO) as well as capillary CO were compared with simultaneous tcPCO.  A total of 124 data points were identified from 50 patients (gestational age [GA] = 28.1 ± 2.4 weeks and birth weight [BW] = 1,035 ± 291 g). Patients were supported with continuous positive airway pressure (40%), noninvasive positive pressure ventilation (16%), mechanical ventilation (18%), and high-frequency oscillation ventilation (24%). PaCO was measured using either capillary (58%) or arterial (42%) samples. Mean CO did not differ between tcPCO (51.3 ± 16) and PaCO (49.1 ± 13.7) mm Hg. tcPCO showed positive correlation with partial pressure of CO ( = 0.6,  < 0.001). This correlation continued to be significant after controlling for GA, postmenstrual age, type of sample, and pH. No skin complications were reported.  tcPCO monitoring using a temperature of 41°C is feasible and reliable in VLBW infants.