Transcutaneous Carbon Dioxide Monitoring with Reduced-Temperature Probes in Very Low Birth Weight Infants

Background Obtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO(2)) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO(2) monitoring using reduced-temperature probes (41 degrees C). Objective The objective of this study was to assess reliability and safety of tcPCO(2) monitoring at reduced-temperature probe in VLBW infants. Design and Methods A prospective study was conducted on VLBW infants. tcPCO(2) was monitored for 12 hours. Default skin probe temperature was adjusted at 41 degrees C. Blood gases were done as clinically indicated. Arterial partial pressure of CO2 (PaCO2) as well as capillary CO2 were compared with simultaneous tcPCO(2). Results A total of 124 data points were identified from 50 patients (gestational age [GA] = 28.1 +/- 2.4 weeks and birth weight [BW] = 1,035 +/- 291 g). Patients were supported with continuous positive airway pressure (40%), noninvasive positive pressure ventilation (16%), mechanical ventilation (18%), and high-frequency oscillation ventilation (24%). PaCO2 was measured using either capillary (58%) or arterial (42%) samples. Mean CO2 did not differ between tcPCO(2) (51.3 +/- 16) and PaCO2 (49.1 +/- 13.7) mm Hg. tcPCO(2) showed positive correlation with partial pressure of CO2 (r = 0.6, p < 0.001). This correlation continued to be significant after controlling for GA, postmenstrual age, type of sample, and pH. No skin complications were reported. Conclusion tcPCO(2) monitoring using a temperature of 41 degrees C is feasible and reliable in VLBW infants.