Related Experiment Video
Updated: Mar 15, 2026
Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Noninvasive Estimation of Arterial CO2 From End-Tidal CO2 in Mechanically Ventilated Children: The GRAeDIENT Pilot
Florent Baudin1, Pierre Bourgoin, David Brossier
11Pediatric Intensive Care Unit, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada.2Pediatric Intensive Care Unit, Department of Pediatrics, HFME-Hospices Civils de Lyon, Bron, France.3Pediatric Intensive Care Unit, Department of Pediatrics, CHU-Nantes, Nantes, France.4Pediatric Intensive Care Unit, Department of Pediatrics, Hôpitaux Universitaires Paris-Sud AP-HP, Kremlin-Bicêtre, Paris.5Research Center, CHU Sainte-Justine, Montreal, QC, Canada.
Objectives:
The aim of our pilot study was to develop a model to better predict Paco2 in mechanically ventilated children using noninvasive parameters including volumetric capnography.
Design:
Prospective clinical pilot study.
Setting:
Level III PICU.
Patients:
Sixty-five mechanically ventilated children.
Interventions:
None.
Materials And Methods:
We conducted a prospective clinical pilot study that included all children admitted to the PICU (< 18 yr; weight, > 3 kg; mechanically ventilated, > 6 hr; with an arterial line). A predictive model for PaCO2 was developed using linear multivariable regression. Among the data collected in PICU patients, candidate predictors of PaCO2 were defined by a panel of experts and included end-tidal partial pressure of carbon dioxide, ventilation parameters, and data resulting from the analysis of volumetric capnogram recorded 5 minutes before an arterial blood gas. Children with tidal volume less than 30 mL were excluded because of technical limits.
Results:
A total of 65 children (43 boys, 65%) (65 [21-150] mo old) were analyzed. By linear multivariable regression, the best model included the mean airway pressure, end-tidal partial pressure of carbon dioxide, FIO2, and the capnographic index with an R equal to 0.90, p value less than 0.001. After correction, 95% (n = 62) of children had an estimated PaCO2 at ± 5 mm Hg.
Conclusion:
Our model developed provides an accurate estimation of the PaCO2 using end-tidal CO2 and noninvasive variables. Studies are needed to validate the equation in PICUs.
More Related Videos
07:51Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor
Published on: September 29, 2020
08:25Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship
Published on: January 8, 2019
Related Concept Videos
01:17Assessment of Diffusion and Perfusion
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:24Diagnosing Acidosis and Alkalosis
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2 and...
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...