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Article: Concordance between side-stream end-tidal carbon dioxide and arterial carbon dioxide partial pressure in respiratory service setting

TitleConcordance between side-stream end-tidal carbon dioxide and arterial carbon dioxide partial pressure in respiratory service setting
Authors
Issue Date2009
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk
Citation
Hong Kong Medical Journal, 2009, v. 15 n. 6, p. 440-446 How to Cite?
Abstract
OBJECTIVE: To explore the correlation and concordance between end-tidal carbon dioxide and arterial carbon dioxide partial pressure, and confirm the experience of the general consensus among service environments. DESIGN: A prospective cross-sectional analysis. SETTING: Two respiratory service units in Hong Kong. PARTICIPANTS: Two hundred respiratory patients were recruited, in whom 219 sets of observations were recorded. Patients deemed to require arterial blood gas determination also had their end-tidal carbon dioxide partial pressure measured at that time, using two LifeSense LS1-9R Capnometers. MAIN OUTCOME MEASURES: The agreement of end-tidal carbon dioxide partial pressure and arterial carbon dioxide partial pressure was studied by correlation coefficients, mean and standard deviation of their difference, and the Bland-Altman plot. RESULTS: Overall, the correlation was low and insignificant (r=0.1185, P=0.0801). The mean of the difference was 7.2 torr (95% confidence interval, 5.5-8.9) and significant (P<0.001). The limits of agreement by Bland-Altman analysis were -18.1 to 32.5 torr, which were too large to be acceptable. In the sub-group on room air, the mean difference was reduced to 2.26 torr, the correlation between end-tidal carbon dioxide partial pressure and arterial carbon dioxide partial pressure was 0.2194 (P=0.0068), though statistically significant, the extent of correlation was still low. CONCLUSION: End-tidal carbon dioxide partial pressure did not show significant correlation or concordance with arterial carbon dioxide partial pressure, especially when supplemental oxygen was used. End-tidal carbon dioxide partial pressure currently cannot replace arterial blood gas measurement as a tool for monitoring arterial carbon dioxide partial pressure. Possible reasons for the discrepancy with previous studies include small sample size in previous studies, lack of research facilities in service settings, and publication bias against negative studies.
Persistent Identifierhttp://hdl.handle.net/10722/135510
ISSN
2013 SCImago Journal Rankings: 0.293

 

Author Affiliations
  1. Kwong Wah Hospital
  2. The University of Hong Kong
  3. Wong Tai Sin Hospital
DC FieldValueLanguage
dc.contributor.authorLaw, GTSen_US
dc.contributor.authorWong, CYen_US
dc.contributor.authorKwan, CWen_US
dc.contributor.authorWong, KYen_US
dc.contributor.authorWong, FPen_US
dc.contributor.authorTse, HNen_US
dc.date.accessioned2011-07-27T01:36:11Z-
dc.date.available2011-07-27T01:36:11Z-
dc.date.issued2009en_US
dc.identifier.citationHong Kong Medical Journal, 2009, v. 15 n. 6, p. 440-446en_US
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/135510-
dc.description.abstractOBJECTIVE: To explore the correlation and concordance between end-tidal carbon dioxide and arterial carbon dioxide partial pressure, and confirm the experience of the general consensus among service environments. DESIGN: A prospective cross-sectional analysis. SETTING: Two respiratory service units in Hong Kong. PARTICIPANTS: Two hundred respiratory patients were recruited, in whom 219 sets of observations were recorded. Patients deemed to require arterial blood gas determination also had their end-tidal carbon dioxide partial pressure measured at that time, using two LifeSense LS1-9R Capnometers. MAIN OUTCOME MEASURES: The agreement of end-tidal carbon dioxide partial pressure and arterial carbon dioxide partial pressure was studied by correlation coefficients, mean and standard deviation of their difference, and the Bland-Altman plot. RESULTS: Overall, the correlation was low and insignificant (r=0.1185, P=0.0801). The mean of the difference was 7.2 torr (95% confidence interval, 5.5-8.9) and significant (P<0.001). The limits of agreement by Bland-Altman analysis were -18.1 to 32.5 torr, which were too large to be acceptable. In the sub-group on room air, the mean difference was reduced to 2.26 torr, the correlation between end-tidal carbon dioxide partial pressure and arterial carbon dioxide partial pressure was 0.2194 (P=0.0068), though statistically significant, the extent of correlation was still low. CONCLUSION: End-tidal carbon dioxide partial pressure did not show significant correlation or concordance with arterial carbon dioxide partial pressure, especially when supplemental oxygen was used. End-tidal carbon dioxide partial pressure currently cannot replace arterial blood gas measurement as a tool for monitoring arterial carbon dioxide partial pressure. Possible reasons for the discrepancy with previous studies include small sample size in previous studies, lack of research facilities in service settings, and publication bias against negative studies.-
dc.languageengen_US
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk-
dc.relation.ispartofHong Kong Medical Journalen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.subject.meshBlood Gas Analysis-
dc.subject.meshBreath Tests - instrumentation - methods-
dc.subject.meshCarbon Dioxide - analysis - blood-
dc.subject.meshPartial Pressure-
dc.subject.meshRespiratory Insufficiency - blood - physiopathology-
dc.titleConcordance between side-stream end-tidal carbon dioxide and arterial carbon dioxide partial pressure in respiratory service settingen_US
dc.typeArticleen_US
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=15&issue=6&spage=440&epage=446&date=2009&atitle=Concordance+between+side-stream+end-tidal+carbon+dioxide+and+arterial+carbon+dioxide+partial+pressure+in+respiratory+service+setting-
dc.identifier.emailKwan, CW: cwkwan@hku.hken_US
dc.description.naturepublished_or_final_version-
dc.identifier.pmid19966348-
dc.identifier.scopuseid_2-s2.0-76749144222-
dc.identifier.hkuros187886en_US
dc.identifier.volume15en_US
dc.identifier.issue6-
dc.identifier.spage440en_US
dc.identifier.epage446en_US

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