Tags

Type your tag names separated by a space and hit enter

Transcutaneous carbon dioxide monitoring during diabetic ketoacidosis in children and adolescents.
Paediatr Anaesth 2004; 14(2):167-71PA

Abstract

OBJECTIVE

Our aim was to evaluate the utility of transcutaneous CO2 (TC-CO2) monitoring in following the response to therapy in children and adolescents in diabetic ketoacidosis (DKA) requiring ICU admission.

METHODS

During therapy for DKA, TC-CO2 was monitored and compared with the serum bicarbonate values (HCO3-). As clinically indicated, serum electrolytes including serum HCO3- were drawn and at the same time, the TC-CO2 value was recorded. Using the TC-CO2 value and the equation (PaCO2=1.5xHCO3-+8), a calculated HCO3- value was determined. The measured serum HCO3- value was subtracted from the calculated HCO3- value and the absolute difference was recorded. The difference between the measured serum HCO3- and the calculated HCO3- was analysed using analysis of variance after stratification for serum HCO3- values and patient age ranges. Calculated to serum HCO3- values were compared using linear regression analysis. In addition, serum HCO3- values were plotted against TC-CO2 values to derive an equation from these data which would relate the TC-CO2 values to the measured serum HCO3-.

RESULTS

The cohort included 28 patients ranging in age from 1.6 to 21 years (9.4 +/- 4.7 years) and in weight from 13 to 96 kg (35.6 +/- 18.2 kg). Two additional patients were not included as the initial TC-CO2 values were inaccurate because of tissue hypoperfusion. In the remaining 28 patients, the absolute difference between the calculated bicarbonate and serum bicarbonate values was 1.5 +/- 1.2 mmol.l-1. The difference was < or =2 mol.l in 74.4% of samples and < or=5 mmol.l(-1) in 99.2%. No difference in the value between the calculated and measured serum HCO3- was present according to serum HCO3- value or patient's age. Linear regression analysis of calculated HCO3- against serum HCO3- revealed a slope of 0.95 and an r2 value of 0.88. Linear regression analysis using serum HCO3- against TC-CO2 resulted in the following equations: TC-CO2=(1.64xHCO3-)+3.9 or HCO3-=0.61x(TC-CO2-3.9).

CONCLUSIONS

TC-CO2 correlates with serum HCO3- and can be used to follow therapy in children and adolescents in DKA.

Authors+Show Affiliations

University of Missouri School of Medicine Departments, The University of Missouri, Columbia, MO 65212, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

14962333

Citation

McBride, Mary E., et al. "Transcutaneous Carbon Dioxide Monitoring During Diabetic Ketoacidosis in Children and Adolescents." Paediatric Anaesthesia, vol. 14, no. 2, 2004, pp. 167-71.
McBride ME, Berkenbosch JW, Tobias JD. Transcutaneous carbon dioxide monitoring during diabetic ketoacidosis in children and adolescents. Paediatr Anaesth. 2004;14(2):167-71.
McBride, M. E., Berkenbosch, J. W., & Tobias, J. D. (2004). Transcutaneous carbon dioxide monitoring during diabetic ketoacidosis in children and adolescents. Paediatric Anaesthesia, 14(2), pp. 167-71.
McBride ME, Berkenbosch JW, Tobias JD. Transcutaneous Carbon Dioxide Monitoring During Diabetic Ketoacidosis in Children and Adolescents. Paediatr Anaesth. 2004;14(2):167-71. PubMed PMID: 14962333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transcutaneous carbon dioxide monitoring during diabetic ketoacidosis in children and adolescents. AU - McBride,Mary E, AU - Berkenbosch,John W, AU - Tobias,Joseph D, PY - 2004/2/14/pubmed PY - 2004/7/28/medline PY - 2004/2/14/entrez SP - 167 EP - 71 JF - Paediatric anaesthesia JO - Paediatr Anaesth VL - 14 IS - 2 N2 - OBJECTIVE: Our aim was to evaluate the utility of transcutaneous CO2 (TC-CO2) monitoring in following the response to therapy in children and adolescents in diabetic ketoacidosis (DKA) requiring ICU admission. METHODS: During therapy for DKA, TC-CO2 was monitored and compared with the serum bicarbonate values (HCO3-). As clinically indicated, serum electrolytes including serum HCO3- were drawn and at the same time, the TC-CO2 value was recorded. Using the TC-CO2 value and the equation (PaCO2=1.5xHCO3-+8), a calculated HCO3- value was determined. The measured serum HCO3- value was subtracted from the calculated HCO3- value and the absolute difference was recorded. The difference between the measured serum HCO3- and the calculated HCO3- was analysed using analysis of variance after stratification for serum HCO3- values and patient age ranges. Calculated to serum HCO3- values were compared using linear regression analysis. In addition, serum HCO3- values were plotted against TC-CO2 values to derive an equation from these data which would relate the TC-CO2 values to the measured serum HCO3-. RESULTS: The cohort included 28 patients ranging in age from 1.6 to 21 years (9.4 +/- 4.7 years) and in weight from 13 to 96 kg (35.6 +/- 18.2 kg). Two additional patients were not included as the initial TC-CO2 values were inaccurate because of tissue hypoperfusion. In the remaining 28 patients, the absolute difference between the calculated bicarbonate and serum bicarbonate values was 1.5 +/- 1.2 mmol.l-1. The difference was < or =2 mol.l in 74.4% of samples and < or=5 mmol.l(-1) in 99.2%. No difference in the value between the calculated and measured serum HCO3- was present according to serum HCO3- value or patient's age. Linear regression analysis of calculated HCO3- against serum HCO3- revealed a slope of 0.95 and an r2 value of 0.88. Linear regression analysis using serum HCO3- against TC-CO2 resulted in the following equations: TC-CO2=(1.64xHCO3-)+3.9 or HCO3-=0.61x(TC-CO2-3.9). CONCLUSIONS: TC-CO2 correlates with serum HCO3- and can be used to follow therapy in children and adolescents in DKA. SN - 1155-5645 UR - https://www.unboundmedicine.com/medline/citation/14962333/Transcutaneous_carbon_dioxide_monitoring_during_diabetic_ketoacidosis_in_children_and_adolescents_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=1155-5645&amp;date=2004&amp;volume=14&amp;issue=2&amp;spage=167 DB - PRIME DP - Unbound Medicine ER -