T A O'Connor1, R Grueber. 1. Division of Neonatology, Children's Hospital, University of Missouri-Columbia, USA.
Abstract
OBJECTIVE: To determine the efficacy of transcutaneous carbon dioxide tension measurement during high-risk neonatal transport. STUDY DESIGN: This was a prospective, randomized comparative study. Infants transported from hospitals more than 30 miles away from our center and who required respiratory intervention were enrolled. Alternating transports used a transcutaneous CO2/O2 monitor. Ventilation parameters and end transport blood gas values served as primary endpoints for the study. RESULTS:Infants withtranscutaneous carbon dioxide tension monitoring were more likely to have decreased ventilator peak pressures during transport than neonates not monitored (-1.5 cm H2O vs + 0.6 cm H2O; p = 0.04). Monitored neonates were more likely to arrive at the tertiary center with a more normal pH and a CO2 tension between 35 and 45 mm Hg (4.7 to 6.0 kPa) than nonmonitored infants (p = 0.03 and p = 0.01, respectively). The stabilization times before transport were not significantly prolonged by the use of the transcutaneous monitor. CONCLUSIONS:Transcutaneous monitoring of CO2 tension improves short-term respiratory outcome in neonates receiving mechanical ventilation during transport.
RCT Entities:
OBJECTIVE: To determine the efficacy of transcutaneous carbon dioxide tension measurement during high-risk neonatal transport. STUDY DESIGN: This was a prospective, randomized comparative study. Infants transported from hospitals more than 30 miles away from our center and who required respiratory intervention were enrolled. Alternating transports used a transcutaneous CO2/O2 monitor. Ventilation parameters and end transport blood gas values served as primary endpoints for the study. RESULTS:Infants with transcutaneous carbon dioxide tension monitoring were more likely to have decreased ventilator peak pressures during transport than neonates not monitored (-1.5 cm H2O vs + 0.6 cm H2O; p = 0.04). Monitored neonates were more likely to arrive at the tertiary center with a more normal pH and a CO2 tension between 35 and 45 mm Hg (4.7 to 6.0 kPa) than nonmonitored infants (p = 0.03 and p = 0.01, respectively). The stabilization times before transport were not significantly prolonged by the use of the transcutaneous monitor. CONCLUSIONS: Transcutaneous monitoring of CO2 tension improves short-term respiratory outcome in neonates receiving mechanical ventilation during transport.
Authors: Emma Persad; Greta Sibrecht; Martin Ringsten; Simon Karlelid; Olga Romantsik; Tommy Ulinder; Israel Júnior Borges do Nascimento; Maria Björklund; Anneliese Arno; Matteo Bruschettini Journal: PLoS One Date: 2021-02-08 Impact factor: 3.240