Continuous Noninvasive Carbon Dioxide Monitoring in Neonates: From Theory to Standard of Care.

Abstract:

:Ventilatory support may affect the short- and long-term neurologic and respiratory morbidities of preterm infants. Ongoing monitoring of oxygenation and ventilation and control of adequate levels of oxygen, pressures, and volumes can decrease the incidence of such adverse outcomes. Use of pulse oximetry became a standard of care for titrating oxygen delivery, but continuous noninvasive monitoring of carbon dioxide (CO2) is not routinely used in NICUs. Continuous monitoring of CO2 level may be crucial because hypocarbia and hypercarbia in extremely preterm infants are associated with lung and brain morbidities, specifically bronchopulmonary dysplasia, intraventricular hemorrhage, and cystic periventricular leukomalacia. It is shown that continuous monitoring of CO2 levels helps in maintaining stable CO2 values within an accepted target range. Continuous monitoring of CO2 levels can be used in the delivery room, during transport, and in infants receiving invasive or noninvasive respiratory support in the NICU. It is logical to hypothesize that this will result in better outcome for extremely preterm infants. In this article, we review the different noninvasive CO2 monitoring alternatives and devices, their advantages and disadvantages, and the available clinical data supporting or negating their use as a standard of care in NICUs.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Hochwald O,Borenstein-Levin L,Dinur G,Jubran H,Ben-David S,Kugelman A

doi

10.1542/peds.2018-3640

subject

Has Abstract

pub_date

2019-07-01 00:00:00

issue

1

eissn

0031-4005

issn

1098-4275

pii

peds.2018-3640

journal_volume

144

pub_type

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