Correlation of End-Tidal Carbon Dioxide with Arterial Carbon Dioxide in Mechanically Ventilated Patients

Abstract

Background: Patients undergone mechanical ventilation need rapid and reliable evaluation of their respiratory status. Monitoring of End-tidal carbon dioxide (ETCO2) as a surrogate, noninvasive measurement of arterial carbon dioxide (PaCO2) is one of the methods used for this purpose in intubated patients.

Objectives: The aim of the present trial was to study the relationship between end-tidal CO2 tensions with PaCO2 measurements in mechanically ventilated patients.

Materials and Methods: End-tidal carbon dioxide levels were recorded at the time of arterial blood gas sampling. Patients who were undergoing one of the mechanical ventilation methods such as: synchronized mandatory mechanical ventilation (SIMV), continuous positive airway pressure (CPAP) and T-Tube were enrolled in this study. The difference between ETCO2 and PaCO2 was tested with a paired t-test. The correlation of end-tidal carbon dioxide to (ETCO2) CO2 was obtained in all patients.

Results: A total of 219 arterial blood gases were obtained from 87 patients (mean age, 71.7 ± 15.1 years). Statistical analysis demonstrated a good correlation between the mean of ETCO2 and PaCO2 in each of the modes of SIMV, CPAP and T-Tube; SIMV (42.5 ± 17.3 and 45.8 ± 17.1; r = 0.893, P < 0.0001), CPAP (37 ± 9.7 and 39.4 ± 10.1; r = 0.841, P < 0.0001) and T-Tube (36.1 ± 9.9 and 39.4 ± 11; r = 0.923, P < 0.0001), respectively.

Conclusions: End-tidal CO2 measurement provides an accurate estimation of PaCO2 in mechanically ventilated patients. Its use may reduce the need for invasive monitoring and/or repeated arterial blood gas analyses.