Can end-tidal CO2 measurement replace arterial partial CO2 in emergency department respiratory distress management?

IF 2.7 4区 医学 Q2 CRITICAL CARE MEDICINE Medicina Intensiva Pub Date : 2024-08-28 DOI:10.1016/j.medin.2024.03.021
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Abstract

Objective

To assess the feasibility of using end-tidal carbon dioxide (EtCO2) as a non-invasive substitute for partial pressure of arterial carbon dioxide (PaCO2) in emergency department (ED) triage and follow-up, and to explore the potential of partial pressure of venous carbon dioxide (PvCO2) as an alternative to PaCO2.

Design

Prospective cross-sectional study.

Setting

Tertiary university hospital.

Patients or participants

97 patients presenting with acute respiratory distress to the ED.

Interventions

EtCO2, arterial blood gases, and venous blood gases measured at admission (0 min), 60 min, and 120 min.

Main variables of interest

CO2 levels.

Results

Among 97 patients (mean age: 70.93 ± 9.6 years; 60.8% male), EtCO2 > 45 mmHg at admission showed strong positive correlations with PaCO2 and PvCO2 (r = 0.844, r = 0.803; p < 0.001, respectively). Significant positive correlation was observed between 60-min EtCO2 and PaCO2 (r = 0.729; p < 0.001). Strong correlation between PaCO2 and PvCO2 at 120 min when EtCO2 > 45 mmHg (r = 0.870; p < 0.001). EtCO2 was higher in hospitalized patients compared to discharged ones.

Conclusions

EtCO2 appears promising as a substitute for PaCO2 in ED patients with acute respiratory distress within the initial two hours of treatment. Venous blood gas sampling offers a less invasive alternative to arterial sampling, facilitating simultaneous blood tests.

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在急诊科呼吸窘迫管理中,潮气末二氧化碳测量能否取代动脉部分二氧化碳测量?
目的 评估在急诊科(ED)分诊和随访中使用潮气末二氧化碳(EtCO2)作为动脉二氧化碳分压(PaCO2)无创替代品的可行性,并探索静脉二氧化碳分压(PvCO2)作为 PaCO2 替代品的潜力。患者或参与者97名急性呼吸窘迫急诊患者。干预措施入院(0 分钟)、60 分钟和 120 分钟时测量 EtCO2、动脉血气和静脉血气。结果在 97 名患者(平均年龄:70.93 ± 9.6 岁;60.8% 为男性)中,入院时的 EtCO2 > 45 mmHg 与 PaCO2 和 PvCO2 呈强正相关(分别为 r = 0.844、r = 0.803;p <0.001)。60 分钟 EtCO2 与 PaCO2 之间呈显著正相关(r = 0.729;p <;0.001)。当 EtCO2 为 45 mmHg 时,120 分钟内 PaCO2 与 PvCO2 之间存在很强的相关性(r = 0.870;p <;0.001)。住院患者的 EtCO2 高于出院患者。静脉血气采样可替代动脉采样,创伤更小,便于同时进行血液检测。
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来源期刊
Medicina Intensiva
Medicina Intensiva CRITICAL CARE MEDICINE-
CiteScore
2.70
自引率
20.00%
发文量
146
审稿时长
33 days
期刊介绍: Medicina Intensiva is the journal of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) and of Pan American and Iberian Federation of Societies of Intensive and Critical Care Medicine. Medicina Intensiva has become the reference publication in Spanish in its field. The journal mainly publishes Original Articles, Reviews, Clinical Notes, Consensus Documents, Images, and other information relevant to the specialty. All works go through a rigorous selection process. The journal accepts submissions of articles in English and in Spanish languages. The journal follows the publication requirements of the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).
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