The American journal of emergency medicine · 2025
The contribution of end-tidal carbon dioxide monitoring to the management of pediatric patients with diabetic ketoacidosis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Kendir Ozlem Tolu, Kahraman Ceren, Tekerek Nazan Ulgen, Gurlu Ramazan, Parlak Mesut, Erkek Nilgun
Аннотация
OBJECTIVE: In this study, the aim is to compare end-tidal carbon dioxide (EtCO2) values monitored in real-time via capnography, with venous blood gas partial pressure of carbon dioxide (PaCO2) values in children diagnosed with diabetic ketoacidosis (DKA) during diagnosis and treatment.
METHODS: A total of 55 patients diagnosed with DKA, aged 0-18 years (mean age: 10.5 ± 4.1 years), were included in this prospective observational study. Of these, 27 had mild-to-moderate DKA and 28 had severe DKA. Patients were grouped as mild-to-moderate or severe based on blood gas values. Vital signs, blood gases and EtCO2 were monitored concomitantly. In this study, the agreement between PaCO2 (blood gas) and EtCO2 (capnography) values was examined, and the diagnostic test performance of EtCO2 and PaCO2 values was evaluated between DKA groups (mild-to-moderate/severe). SPSS (Statistical Package for the Social Sciences) version 25.0 software was used for statistical analysis.
RESULTS: A positive linear correlation was found between EtCO2 and PaCO2 values at admission and throughout monitoring. For detecting patients with GCS ≤ 13, the cut-off values were EtCO2 < 12 mmHg and PaCO2 < 12.1 mmHg. The sensitivity, specificity, and AUC for EtCO2 were 78.57 %, 92.59 %, and 0.907, respectively; and for PaCO2, 25 %, 100 %, and 0.665, respectively.
CONCLUSION: Our results show that patients with DKA can be monitored instantly with EtCO2, thereby reducing the need for invasive procedures in children.
CLINICAL TRIALS NUMBER: NCT06327737.
METHODS: A total of 55 patients diagnosed with DKA, aged 0-18 years (mean age: 10.5 ± 4.1 years), were included in this prospective observational study. Of these, 27 had mild-to-moderate DKA and 28 had severe DKA. Patients were grouped as mild-to-moderate or severe based on blood gas values. Vital signs, blood gases and EtCO2 were monitored concomitantly. In this study, the agreement between PaCO2 (blood gas) and EtCO2 (capnography) values was examined, and the diagnostic test performance of EtCO2 and PaCO2 values was evaluated between DKA groups (mild-to-moderate/severe). SPSS (Statistical Package for the Social Sciences) version 25.0 software was used for statistical analysis.
RESULTS: A positive linear correlation was found between EtCO2 and PaCO2 values at admission and throughout monitoring. For detecting patients with GCS ≤ 13, the cut-off values were EtCO2 < 12 mmHg and PaCO2 < 12.1 mmHg. The sensitivity, specificity, and AUC for EtCO2 were 78.57 %, 92.59 %, and 0.907, respectively; and for PaCO2, 25 %, 100 %, and 0.665, respectively.
CONCLUSION: Our results show that patients with DKA can be monitored instantly with EtCO2, thereby reducing the need for invasive procedures in children.
CLINICAL TRIALS NUMBER: NCT06327737.