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Estimation of arterial CO2 partial pressure by measurement of tracheal CO2 during high-frequency jet ventilation in patients with a laryngectomy

Published online by Cambridge University Press:  16 August 2006

V. Novak-Janković ,
V. Paver-Eržen ,
I. Fajdiga ,
J. G. Bovill ,
A. Manohin  and
M. Žargi
V. Novak-Janković
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenija
V. Paver-Eržen
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenija
I. Fajdiga
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenija
J. G. Bovill
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenija
A. Manohin
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenija
M. Žargi
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenija
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Abstract

Tracheal and arterial CO2 partial pressures were measured simultaneously in 27 laryngectomized patients both while they were awake and during high-frequency jet ventilation. Tracheal gas was sampled during brief interruptions of high-frequency jet ventilation. Agreement between tracheal and arterial CO2 partial pressures was assessed using the Bland–Altman method. The tracheal–arterial CO2 partial pressures gradient during spontaneous breathing was significantly lower (P<0.0002) than during high-frequency jet ventilation. During spontaneous ventilation, the bias was −0.77 kPa (95% CI= −0.99 to −0.55 kPa), and the upper and lower limits of agreement were 0.29 kPa (95% CI= −0.11 to −0.7 kPa) and −1.83 kPa (95% CI= −2.24 to −1.43 kPa). During high-frequency jet ventilation, the bias was −1.61 kPa (95% CI= −1.76 to −1.46 kPa), and the limits of agreement were −0.48 kPa (95% CI= −0.75 to −0.21 kPa) and −2.74 kPa (95% CI= −3.01 to −2.47 kPa). Despite the poor agreement between tracheal CO2 partial pressure and arterial CO2 partial pressure, it is sufficient to allow for adjustment of ventilator settings during jet ventilation.

Keywords

ventilationhigh frequencymonitoringcarbon dioxidearterialtrachealpartial pressure
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 15 , Issue 1 , January 1998 , pp. 1 - 5
Copyright
1998 European Society of Anaesthesiology

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