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Background and Aim:
Arterial carbon dioxide tension (PaCO2) is considered the gold standard for scrupulous monitoring in pediatric intensive care unit (PICU), but it is invasive, laborious, expensive, and intermittent. The study aims to explore when we can use end-tidal carbon dioxide tension (PETCO2) as a reliable, continuous, and noninvasive monitor of arterial CO2Materials and Methods:
Concurrent PETCO2, fraction of inspired oxygen, PaCO2, and arterial oxygen tension values of clinically stable children on mechanical ventilation were recorded. Children with extra-pulmonary ventriculoatrial shunts were excluded. The PETCO2 and PaCO2 difference and its variability and reproducibility were studied.Results:
A total of 624 concurrent readings were obtained from 105 children (mean age [SD] 5.53 [5.43] years) requiring invasive bi-level positive airway pressure ventilation in the PICU. All had continuous PETCO2 monitoring and an arterial line for blood gas measurement. The mean (SD) number of concurrent readings obtained from each child, 4-6 h apart was 6.0 (4.05). The PETCO2 values were higher than PaCO2 in 142 observations (22.7%). The PaCO2–PETCO2 difference was individual admission specific (ANOVA, P < 0.001). The PaCO2–PETCO2 difference correlated positively with the alveolar-arterial oxygen tension [P(A-a)O2] difference (ρ = 0.381 P < 0.0001). There was a fixed bias between the PETCO2 and PaCO2 measuring methods, difference +0.66 KPa (95% confidence interval: +0.57 to +0.76).Conclusions:
The PaCO2–PETCO2 difference was individual specific. It was not affected by the primary disorder leading to the ventilation. 相似文献Aims: To evaluate the role of massage therapy for reduction of NNH in both term and preterm neonates.
Method: The literature search was done for various randomized control trials (RCTs) by searching the Cochrane Library, PubMed, and EMBASE.
Results: This review included total of 10 RCTs (two in preterm neonates and eight in term neonates) that fulfilled inclusion criteria. In most of the trials, Field massage was given. Six out of eight trials reported reduction in bilirubin levels in term neonates. However, only one trial (out of two) reported significant reduction in bilirubin levels in preterm neonates. Both trials in preterm neonates and most of the trials in term neonates (five trials) reported increased stool frequencies.
Conclusion: Role of massage therapy in the management of NNH is supported by the current evidence. However, due to limitations of the trials, current evidences are not sufficient to use massage therapy for the management of NNH in routine practice. 相似文献