Abstract 334: Noninvasive Carbon Dioxide Monitoring During Acute Lung Injury Due to Smoke Inhalation and Burns
Introduction: We evaluated the accuracy of transcutaneous CO2 (tPCO2) and end-tidal CO2 (ETCO2) monitors in a porcine model of Acute Lung Injury (ALI) due to smoke inhalation and burns.
Methods: Anesthetized pigs (n=6) received smoke inhalation injury and 40% total body surface area (TBSA) full-thickness flame burns. They were then transferred to an animal ICU. A SenTec system was used for tPCO2 measurements, and an Oridion Capnostream for ETCO2. PaCO2 was analyzed with an i-STAT blood analyzer. These measurements were recorded every 6 hrs and as needed. Data are means ±SD, and were analyzed (Bland-Altman and linear regression) both pre- and post-ALI, as well as during hemodynamically stable and unstable (unstable = mean arterial pressure (MAP) < 60 mmHg or receiving i.v.norepinephrine).
Results: See Table. All animals developed ALI (PaO2/FiO2 <300) at 23.5±15.1 hrs. Mean survival time was 46.3 ± 26.3 hrs.
Conclusions: In a porcine model of ALI and under hemodynamically stable conditions, tPCO2 was an acceptable surrogate for PaCO2 and was more accurate than ETCO2. Overall, tPCO2 monitoring is a consistent noninvasive substitute for PaCO2. Its shortcomings include a slower response time to PaCO2 changes than ETCO2.
- © 2012 by American Heart Association, Inc.