{"title":"Can end-tidal CO2 measurement replace arterial partial CO2 in emergency department respiratory distress management?","authors":"","doi":"10.1016/j.medin.2024.03.021","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To assess the feasibility of using end-tidal carbon dioxide (EtCO<sub>2</sub>) as a non-invasive substitute for partial pressure of arterial carbon dioxide (PaCO<sub>2</sub>) in emergency department (ED) triage and follow-up, and to explore the potential of partial pressure of venous carbon dioxide (PvCO<sub>2</sub>) as an alternative to PaCO<sub>2</sub>.</p></div><div><h3>Design</h3><p>Prospective cross-sectional study.</p></div><div><h3>Setting</h3><p>Tertiary university hospital.</p></div><div><h3>Patients or participants</h3><p>97 patients presenting with acute respiratory distress to the ED.</p></div><div><h3>Interventions</h3><p>EtCO<sub>2</sub>, arterial blood gases, and venous blood gases measured at admission (0 min), 60 min, and 120 min.</p></div><div><h3>Main variables of interest</h3><p>CO<sub>2</sub> levels.</p></div><div><h3>Results</h3><p>Among 97 patients (mean age: 70.93 ± 9.6 years; 60.8% male), EtCO<sub>2</sub> > 45 mmHg at admission showed strong positive correlations with PaCO<sub>2</sub> and PvCO<sub>2</sub> (<em>r</em> = 0.844, <em>r</em> = 0.803; <em>p</em> < 0.001, respectively). Significant positive correlation was observed between 60-min EtCO<sub>2</sub> and PaCO<sub>2</sub> (<em>r</em> = 0.729; <em>p</em> < 0.001). Strong correlation between PaCO<sub>2</sub> and PvCO<sub>2</sub> at 120 min when EtCO<sub>2</sub> > 45 mmHg (<em>r</em> = 0.870; <em>p</em> < 0.001). EtCO<sub>2</sub> was higher in hospitalized patients compared to discharged ones.</p></div><div><h3>Conclusions</h3><p>EtCO<sub>2</sub> appears promising as a substitute for PaCO<sub>2</sub> 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.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina Intensiva","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0210569124001189","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
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.
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).