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Capnography in spontaneously breathing preterm infants with bronchopulmonary dysplasia

Emmanuel Lopez1, Jihene Mathlouthi, Sandra Lescure

  • 1AP-HP, Groupe Hospitalier Cochin-Saint Vincent de Paul, Service de Médecine Néonatale de Port-Royal, Paris, France. emmanuel.lopez@cch.aphp.fr

Pediatric Pulmonology
|April 6, 2011
PubMed

Insights

Infants with bronchopulmonary dysplasia (BPD) show a larger gradient between end-tidal and arterial carbon dioxide, indicating potential ventilation-perfusion mismatch. Their capnogram shape differs from healthy infants, but not typical of airway obstruction.

Area of Science:

  • Neonatal respiratory physiology
  • Pediatric pulmonology

Background:

  • Adult chronic obstructive pulmonary disease (COPD) exhibits a gradient between end-tidal carbon dioxide (EtCO2) and arterial carbon dioxide pressure (PaCO2), with a decreased capnogram ascending slope.
  • Data on this gradient and capnogram shape in infants with bronchopulmonary dysplasia (BPD) are limited.

Purpose of the Study:

  • To compare the PCO2-EtCO2 gradient and capnogram shape in preterm infants with BPD versus healthy controls.
  • To investigate potential ventilation-perfusion mismatch in infants with BPD.

Main Methods:

  • Capnography was performed at 36 weeks postmenstrual age in 20 infants (12 BPD, 8 controls).
  • Respiratory rate and respiratory cycle components were measured.
  • The PCO2-EtCO2 gradient was calculated using EtCO2 and simultaneously sampled capillary PCO2 (PcCO2).

Main Results:

  • Infants with BPD had a higher respiratory rate (60 ± 16 bpm vs 43 ± 16 bpm).
  • A significantly widened PcCO2-EtCO2 gradient was observed in BPD infants (13 ± 4 mmHg vs 0 ± 7 mmHg).
  • The ascending phase of the capnogram was not decreased, but the initial inspiratory phase was prolonged in BPD infants.

Conclusions:

  • Infants with BPD exhibit a higher PcCO2-EtCO2 gradient, suggesting possible ventilation-perfusion mismatch.
  • The capnogram shape in BPD infants did not show the characteristic pattern of airway obstruction seen in adults with COPD.
Abstract

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