Exhaled Carbon Dioxide Monitoring Using Instantaneous CO₂ Mode During High-Frequency Oscillatory Ventilation in Very Low Birth Weight Infants.

IF 2.3 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-10-01 DOI:10.1002/ppul.71323

Yusuke Nakazawa, Kazuto Ueda, Yoshihiro Tanahashi, Toshiki Aoki, Yoshiaki Sato

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引用次数: 0

Abstract

Background: High-frequency oscillatory ventilation (HFOV) presents challenges for noninvasive CO₂ monitoring due to its rapid oscillations. This study examines the feasibility of instantaneous CO₂ partial pressure (INST CO₂) monitoring during HFOV with a capnometer equipped with a mainstream CO₂ sensor.

Methods: This study included seven neonates receiving HFOV in the neonatal intensive care unit (NICU) at Shizuoka Children's Hospital. INST CO₂ values were recorded over 3- and 5-min intervals surrounding each blood gas sampling to determine the maximum INST CO₂ value (INST CO₂ MX). The primary outcome was the correlation between INST CO₂ MX and arterial partial pressure of carbon dioxide (PCO₂).

Results: A total of 216 paired INST CO₂ MX and PCO₂ values were analyzed. The coefficient of determination (R²) was 0.571 for INST CO₂ MX (3 min) and 0.579 for INST CO₂ MX (5 min). Univariable and multivariable analyses revealed that a lower fraction of inspired oxygen (FiO₂), reduced minute ventilation, and increased postnatal age were associated with improved concordance between INST CO₂ MX and PCO₂.

Conclusion: INST CO₂ MX demonstrated a strong correlation with PCO₂ in neonates undergoing HFOV. This novel, noninvasive monitoring approach may serve as a valuable tool for neonatal respiratory management. Future research is needed to validate these findings in broader patient populations and across various ventilatory settings.

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极低出生体重儿高频振荡通气过程中瞬时CO2模式的呼出二氧化碳监测。

背景：高频振荡通气（HFOV）由于其快速振荡，对无创CO2监测提出了挑战。本研究探讨了在HFOV中使用配备主流CO2传感器的capometer进行瞬时CO2分压（INST CO2）监测的可行性。方法：本研究纳入静冈县儿童医院新生儿重症监护病房（NICU）接受HFOV治疗的7例新生儿。在每次血气采样前后间隔3分钟和5分钟记录INST CO2值，以确定最大INST CO2值（INST CO2 MX）。主要结局是INST CO2 MX与动脉二氧化碳分压（PCO2）的相关性。结果：共分析了216个配对的INST CO2 MX和PCO2值。INST CO2 MX （3 min）的决定系数（R2）为0.571,INST CO2 MX （5 min）的决定系数为0.579。单变量和多变量分析显示，较低的吸入氧（FiO2）比例、减少的分钟通气量和出生后年龄的增加与INST CO2 MX和PCO2之间的一致性改善有关。结论：HFOV新生儿的INST CO2 MX与PCO2有很强的相关性。这种新颖的、无创的监测方法可以作为新生儿呼吸管理的有价值的工具。未来的研究需要在更广泛的患者群体和不同的通气设置中验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.