Evaluating a novel formula for noninvasive estimation of arterial carbon dioxide during post-resuscitation care

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Rentola , R R , Skrifvars , M B , Heinonen , E , Häggblom , T & Hästbacka , J 2020 , ' Evaluating a novel formula for noninvasive estimation of arterial carbon dioxide during post-resuscitation care ' , Acta Anaesthesiologica Scandinavica , vol. 64 , no. 9 , pp. 1287-1294 . https://doi.org/10.1111/aas.13652

Title: Evaluating a novel formula for noninvasive estimation of arterial carbon dioxide during post-resuscitation care
Author: Rentola, Raisa R.; Skrifvars, Markus B.; Heinonen, Erkki; Häggblom, Tom; Hästbacka, Johanna
Contributor: University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUS Emergency Medicine and Services
University of Helsinki, Clinicum
Date: 2020-10
Language: eng
Number of pages: 8
Belongs to series: Acta Anaesthesiologica Scandinavica
ISSN: 0001-5172
URI: http://hdl.handle.net/10138/331656
Abstract: Background Controlling arterial carbon dioxide is paramount in mechanically ventilated patients, and an accurate and continuous noninvasive monitoring method would optimize management in dynamic situations. In this study, we validated and further refined formulas for estimating partial pressure of carbon dioxide with respiratory gas and pulse oximetry data in mechanically ventilated cardiac arrest patients. Methods A total of 4741 data sets were collected retrospectively from 233 resuscitated patients undergoing therapeutic hypothermia. The original formula used to analyze the data is PaCO2-est1 = PETCO2 + k[(PIO2 - PETCO2) - PaO2]. To achieve better accuracy, we further modified the formula to PaCO2-est2 = k(1)*PETCO2 + k(2)*(PIO2 - PETCO2) + k(3)*(100-SpO(2)). The coefficients were determined by identifying the minimal difference between the measured and calculated arterial carbon dioxide values in a development set. The accuracy of these two methods was compared with the estimation of the partial pressure of carbon dioxide using end-tidal carbon dioxide. Results With PaCO2-est1, the mean difference between the partial pressure of carbon dioxide, and the estimated carbon dioxide was 0.08 kPa (SE +/- 0.003); with PaCO2-est2 the difference was 0.036 kPa (SE +/- 0.009). The mean difference between the partial pressure of carbon dioxide and end-tidal carbon dioxide was 0.72 kPa (SE +/- 0.01). In a mixed linear model, there was a significant difference between the estimation using end-tidal carbon dioxide and PaCO2-est1 (P <.001) and PaCO2-est2 (P <.001) respectively. Conclusions This novel formula appears to provide an accurate, continuous, and noninvasive estimation of arterial carbon dioxide.
Subject: PCO2
FAILURE
TENSION
PCO(2)
SCORE
3126 Surgery, anesthesiology, intensive care, radiology
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