Skip to main content

Advertisement

Noninvasive monitoring capnometry for continuous monitoring of metabolic status in pediatric diabetic ketoacidosis (DKA)

Purpose

Patients with diabetic ketoacidosis (DKA) have complex metabolic abnormalities and manifest a low pCO2 as result of respiratory compensation. During treatment, as venous pH improves, respiratory rate (RR) decreases causing an increase in pCO2. To determine the reliability and clinical value of continous ETCO2 by oral/nasal capnometry for monitoring the metabolic status of the pediatric DKA patient.

Design/setting

Prospective observational study, university affiliated children's hospital E/R.

Materials and methods

Patients with pH of 7.33 or less with evidence of hyperglycemia, ketosis and between the age of 1 year to 18 years of age were enrolled. ETCO2 measurements was obtained by continuous oral/nasal side stream capnometry and vital signs were recorded every 15 min. Venous blood gases analyses were obtained every 1–2 hours with simultaneous recorded ETCO2, (RR). ETCO2 measurements were compared with venous pCO2 and changes in respiratory rates.

Results

A total of 121 patients were monitored for a mean of 5.9 hours. Age ranged from 1.8 to 18 years, mean of 10.9 ± 5.2 years. Patient disposition were admitted to PICU or Wards or discharged to home.

ETCO2 correlated with pCO2R = 0.92 P = 0.0001, pH R = 0.88 P = 0.0001 and inversely correlated with respiratory rate R = -0.79 P = 0.0001. The concordance correlation for first (R = 0.93 P = 0.0001), last (R = 0.60 P = 0.0001) and all (R = 0.92 P = 0.0001) observation between ETCO2 and pCO2 were significant.

Conculsion

Dependable noninvasive continuous ETCO2 monitoring can be obtained using oral/nasal capnometry circuits and reflect metabolic changes in the pediatric DKA patient. We have demonstrated that continous end-tidal CO2 monitoring can be used as a nonivasive assessment of the metabolic status of the pediatric patient in DKA.

Table 1 Table 1

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Abramo, T., Wiebe, R., Garcia, E. et al. Noninvasive monitoring capnometry for continuous monitoring of metabolic status in pediatric diabetic ketoacidosis (DKA). Crit Care 5, P132 (2001). https://doi.org/10.1186/cc1199

Download citation

Keywords

  • Respiratory Rate
  • Metabolic Status
  • Diabetic Ketoacidosis
  • Patient Disposition
  • Concordance Correlation