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Related Experiment Videos

Continuous end-tidal CO2 in pediatric bronchoscopy

L M Franchi1, J C Maggi, E Nussbaum

  • 1Memorial Miller Children's Hospital, Department of Pediatrics, University of California, Irvine, Long Beach 90801-1428.

Pediatric Pulmonology
|September 1, 1993
PubMed
Summary
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Flexible fiberoptic bronchoscopy (FFB) in children can cause decreases in end-tidal PCO2 (PetCO2) and SpO2, even with oxygen. PetCO2 changes may predict SpO2 drops, suggesting airway obstruction during FFB.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology
  • Medical Devices

Background:

  • Flexible fiberoptic bronchoscopy (FFB) is utilized for pediatric diagnostic and therapeutic procedures.
  • Sedation and instrument insertion during FFB can compromise ventilation, potentially causing hypoxemia and desaturation.
  • Current monitoring typically relies on pulse oximetry (SpO2), with end-tidal PCO2 (PetCO2) not routinely employed.

Purpose of the Study:

  • To prospectively evaluate changes in PetCO2 and SpO2 during FFB in pediatric patients.
  • To investigate the relationship between PetCO2 and SpO2 variations during the procedure.
  • To explore the potential utility of PetCO2 monitoring in pediatric FFB.

Main Methods:

  • Twenty-two pediatric patients (15 days to 18 years) undergoing FFB with supplemental oxygen were studied.

Related Experiment Videos

  • Continuous measurements of PetCO2 and SpO2 were recorded before and during FFB.
  • Data analysis focused on changes in mean PetCO2 and SpO2 levels and their temporal relationship.

    • Main Results:

    • Mean PetCO2 decreased significantly from 33.9 mmHg to 27.1 mmHg during FFB (P < 0.024).
    • Mean SpO2 also decreased significantly from 99.9% to 95.7% during FFB (P < 0.015).
    • PetCO2 changes appeared to precede SpO2 variations, particularly in younger patients experiencing desaturation.

    Conclusions:

    • Both PetCO2 and SpO2 decrease during FFB in children, even with supplemental oxygen.
    • The observed decreases may indicate airway obstruction by the bronchoscope.
    • Further research is warranted to determine the clinical value of PetCO2 monitoring in pediatric FFB.