Noninvasive carbon dioxide monitoring in pediatric patients undergoing laparoscopic surgery: transcutaneous vs....

The present study aimed to investigate the correlation between transcutaneous carbon dioxide partial pressure (PtcCO₂) and arterial carbon dioxide pressure (PaCO₂) and the accuracy of PtcCO₂ in predicting PaCO₂ during laparoscopic surgery in pediatric patients.

Children aged 2-8 years with American Society of Anesthesiologists (ASA) class I or II who underwent laparoscopic surgery under general anesthesia were selected. After anesthesia induction and tracheal intubation, PtcCO₂ was monitored, and radial arterial catheterization was performed for continuous pressure measurement. PaCO₂, PtcCO₂, and end-tidal carbon dioxide partial pressure (PetCO₂) were measured before pneumoperitoneum, and 30, 60, and 90 min after pneumoperitoneum, respectively. The correlation and agreement between PtcCO₂ and PaCO₂, PetCO₂, and PaCO₂ were evaluated.

A total of 32 patients were eventually enrolled in this study, resulting in 128 datasets. The linear regression equations were: PtcCO₂ = 7.89 + 0.82 × PaCO₂ (r² = 0.70, P < 0.01); PetCO₂ = 9.87 + 0.64 × PaCO₂ (r² = 0.69, P < 0.01). The 95% limits of agreement (LOA) of PtcCO₂ - PaCO₂ average was 0.66 ± 4.92 mmHg, and the 95% LOA of PetCO₂ - PaCO₂ average was -4.4 ± 4.86 mmHg. A difference of ≤ 5 mmHg was noted between PtcCO₂ and PaCO₂ in 122/128 samples and between PetCO₂ and PaCO₂ in 81/128 samples (P < 0.01).

In pediatric laparoscopic surgery, a close correlation was established between PtcCO₂ and PaCO₂. Compared to PetCO₂, PtcCO₂ can estimate PaCO₂ accurately and could be used as an auxiliary monitoring indicator to optimize anesthesia management for laparoscopic surgery in children; however, it is not a substitute for PetCO₂.

ChiCTR2100043636.