| Titre : | Carbon dioxide monitoring during long term noninvasive respiratory support in children |
| contenu dans : | |
| Auteurs : | Collectif ; Paiva R ; Aubertin A ; Cohen C ; Clément A ; Fauroux B |
| Type de document : | Article |
| Année de publication : | 2009 |
| Pages : | p. 36 |
| Langues: | Anglais |
| Résumé : | Introduction : Noninvasive respiratory support is increasingly used in children to correct nocturnal hypoventilation. Routine monitoring relies on nocturnal pulse oximetry and daytime arterial blood gases, without a systematic nocturnal carbon dioxide recording. The aim of the study was to assess if overnight pulse oximetry and capillary arterialized blood gases are sufficiently accurate to detect persistent nocturnal hypoventilation in children receiving long term noninvasive respiratory support. Material and methods : Pulse oximetry and carbon dioxide pressure measured by capillary arterialized blood gases and a combined transcutaneous carbon dioxide and pulse oximetry (PtcCO2/SpO2) monitor were compared in 80 pediatric patients referred to the lung function laboratory. Daytime capillary arterialized blood gases and nocturnal recording of pulse oximetry and carbon dioxide by means of a combined PtcCO2/SpO2 monitor were performed in 50 other children receiving nocturnal noninvasive respiratory support at home. Results : A correlation was observed between pulse oximetry (r=0.832, p<0.0001) and carbon dioxide pressure (r=0.644, p<0.0001) measured by capillary arterialized blood gases and the combined PtcCO2/SpO2 monitor. Twenty one of the 50 patients (42%) on long term noninvasive respiratory support presented nocturnal hypercapnia, defined by a PtcCO2 value > 50mmHg, without nocturnal hypoxemia. Daytime capillary arterialized carbon dioxide levels were normal in 18 of these 21 patients. Conclusions : Nocturnal hypercapniamay occur in children receiving nocturnal noninvasive respiratory support at home. Nocturnal pulse oximetry and daytime arterial blood gases are not sufficiently accurate to diagnose nocturnal hypercapnia, underlying the importance of a systematic carbon dioxide monitoring in children receiving noninvasive respiratory support. |
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