Division of Neonatology, Fukuda Hospital, Kumamoto, Japan.
Division of Pediatrics, Fukuda Hospital, Kumamoto, Japan.
J Perinatol. 2021 Jan;41(1):47-52. doi: 10.1038/s41372-020-0758-2. Epub 2020 Aug 4.
To examine the extents to which low tidal volume (VT) and endotracheal tube (ETT) leakeage influence the accuracy of ETCO for estimating arterial PCO (PaCO) in very low birth weight (VLBW) infants with mechanical ventilation.
An observational study. We evaluated a total of 287 paired ETCO and PaCO values as well as VTs obtained from 22 VLBW infants with ventilation. Deming regression, quadratic discriminant analysis, and Bland-Altman analysis were performed.
ETCO and PaCO were correlated (r = 0.5897, p < 0.0001). A quadratic discrimination analysis of the VT and the percentage of leak yielded 70.4% [95%CI, 65.1 to 75.7] discrimination for the agreement between ETCO and PaCO. ETCO was strongly correlated with PaCO in the discriminant function Z > 0 group (r = 0.7234, p < 0.0001).
Our results indicate that ETCO is a good surrogate for PaCO when VT is high and ETT leak is low.
研究小潮气量（VT）和气管内导管（ETT）泄漏对机械通气极低出生体重（VLBW）婴儿 ETCO 估计动脉 PCO（PaCO）准确性的影响程度。
观察性研究。我们评估了 22 名接受通气的 VLBW 婴儿共 287 对 ETCO 和 PaCO 值以及 VTs。进行了 Deming 回归、二次判别分析和 Bland-Altman 分析。
ETCO 和 PaCO 呈相关关系（r=0.5897，p<0.0001）。对 VT 和泄漏百分比的二次判别分析得出，VT 和泄漏百分比的判别函数 Z>0 组中，ETCO 和 PaCO 之间的一致性为 70.4%[95%CI，65.1 至 75.7]。在判别函数 Z>0 组中，ETCO 与 PaCO 呈强相关（r=0.7234，p<0.0001）。
当 VT 较高且 ETT 泄漏较低时，ETCO 是 PaCO 的良好替代指标。
