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J Neurocrit Care 2011;4(2): 50-55.
Monitoring of End-Tidal CO2: Benefits to Critically Ill Neurological Patients
Mi-Yeon Eun, MD and Woo-Keun Seo, MD, PhD
Department of Neurology, Korea University College of Medicine, Seoul, Korea
Background: There have been few studies about the application of end-tidal CO2 (PetCO2) monitoring in neurologic disorders. The purpose of this study was to evaluate the correlation of PetCO2 and arterial CO2 (PaCO2) in critically ill neurological patients.
Methods: Patients with neurological disorders were monitored with sidestream capnometry while in the intensive care unit. Simultaneously, arterial blood gases were analyzed with a portable blood-gas analyzer. PetCO2 levels correlated with PaCO2 levels, based on neurologic diagnosis, presence of cardiopulmonary insufficiency, and ventilation state.
Results: From 24 patients (12 female, mean age 60.5±14.0 years old), 208 PetCO2 records were measured. The mean PetCO2 was 30.63±7.34 mm Hg and the mean PaCO2 was 38.20±8.84 mm Hg. There was a linear correlation between PetCO2 and PaCO2 (correlation coefficient=0.411, P<0.001). In both the central nervous system (CNS) and peripheral neuromuscular disease (PNS) groups, a linear correlation between PetCO2 and PaCO2 was also found, and the PNS group showed a higher correlation coefficient (0.648, P<0.001) than the CNS group (0.245, P=0.006). There was a correlation between PetCO2 and PaCO2 in the hypocapnia group, independent of cardiopulmonary insufficiency. However, no correlation between Pet- CO2 and PaCO2 was found in the hypercapnia group.
Conclusions: PetCO2 correlated with PaCO2 in critically ill neurological patients. Despite of some limitation, PetCO2 monitoring could be used to assess ventilation and pulmonary perfusion in the diagnosis and management of neurological disorders.
Key Words: Capnometry · Neurology · Critical care
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