![]() While the effects of ETT leakage on the monitoring of VT and respiratory mechanics have been well investigated, little is known about the extents to which low VTs and ETT leakage influence the agreement between ETCO 2 and PaCO 2. ![]() The main problem with capnography in infants is the low tidal volume (VT) and leakage from tracheal intubation, which is often observed when using uncuffed ETTs. Furthermore, the difficulty in acquiring adequate CO 2 waveforms due to tachypnea and ventilation–perfusion mismatch affects the accuracy of ETCO 2. However, capnography has not been widely accepted by neonatologists for physiological and technical reasons, such as the weight of sensors or water droplets within circuits, dead space, and leakage from tracheal intubation tubes. Several investigators have demonstrated that ETCO 2 was in good correlation with PaCO 2 values in infants, including extremely low birth weight infants. The use of end-tidal CO 2 (ETCO 2) for monitoring and as a tool for verifying endotracheal tube (ETT) position is another standard technique. ![]() Therefore, careful monitoring of respiratory mechanics, including CO 2, is necessary during mechanical ventilation to prevent volutrauma and chronic lung disease.Ĭapnography, which displays the level and waveform of CO 2 in expired breaths, is a simple and well-established standard monitoring technique that indicates arterial PCO 2 (PaCO 2) and provides information on cell metabolism, blood perfusion, and alveolar ventilation in adult and pediatric patients. The preterm lung is highly fragile because the lung is structurally immature and deficient in surfactant, and lung overdistension can cause pulmonary inflammation leading to lung injury.
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