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Transcutaneous monitoring as a replacement for arterial PCO(2) monitoring during nocturnal non-invasive ventilation
Storre J.H., et al. Respiratory Med. 2011.
"Although the measurement of [PaCO2] is regarded as the gold standard technique for PCO2 assessment, it is an invasive and painful method requiring an ABG analysis... and only reflects a snapshot of the potentially varying ventilatory status..."
Transcutaneous carbon dioxide monitoring with reduced-temperature probes in very low birth weight infants
Aly S., et al. American Journal of Perinatology. 2017.
In this study, 50 preterm infants under 1500g were monitored for 12 hours with Sentec transcutaneous monitoring, and no skin harm was detected.
Impact of continuous capnography in ventilated neonates: a randomized, multicenter study
Kugelman A., et al. The Journal of Pediatrics. 2016.
This study found that continuous CO2 visibility was linked to significantly less time at unsafe CO2 levels and a lower rate of IVH and PVL in the patient group with visible CO2 values.
Neonatal transcutaneous carbon dioxide monitoring–effect on clinical management and outcomes
Mukhopadhyay S., et al. Respiratory Care. 2016.
A study at Children’s Hospital of Pennsylvania’s then level III NICU found that introducing transcutaneous monitoring led to a ~25% reduction in blood gas tests for ventilated patients.
Continuous noninvasive carbon dioxide monitoring in neonates: from theory to standard of care
Hochwald O., et al. Pediatrics. 2019.
This review establishes the connection between abnormal carbon dioxide levels and intraventricular hemorrhage (IVH), as well as the need for titrated ventilatory support to protect neonatal lungs.
A quality improvement bundle to improve outcomes in extremely preterm infants in the first week
Travers, C.P., et al. Pediatrics. 2022.
The NICU at UAB reduced the rate of severe ICH or death in the first week after birth by over 10% after implementing a care bundle, which included transcutaneous monitoring to target a CO2 range of 40-60 mmHg.
Iatrogenic blood loss in extreme preterm infants due to frequent laboratory tests and procedures
Counsilman C.E., et al. Journal of Maternal-Fetal and Neonatal Medicine. 2019.
This article links frequent blood sampling to iatrogenic anemia, transfusion, and related risks. The authors recommend using transcutaneous monitoring as part of a comprehensive approach to minimize blood loss in the NICU.
Pain Management in Newborns
Hall R.W., et al. Clinics in Perinatology. 2014.
This review article highlights short- and long-term behavioral and neurological adverse outcomes from neonatal pain and recommends a rigorous pain reduction strategy. It emphasizes reducing blood sampling frequency, with noninvasive monitoring playing a key role.
Attributable cost and length of stay for central line-associated bloodstream infections
Goudie A., et al. Pediatrics. 2014.
Some studies suggest using central lines for patients needing frequent heel sticks. However, institutions may limit central line draws for CO2 monitoring due to associated risks. This study found that CLABSIs lead to about a 30-day longer hospital stay and an additional $90,000 in costs per patient.
Frequent tracheal suctioning is associated with extubation failure in patients with successful spontaneous breathing trial: a single-center retrospective cohort study
Haruna, J. et al. Journal of Anesthesia Clinical Reports. 2022.
In a single-center retrospective study of ICU patients intubated for over 72 hours and extubated after a spontaneous breathing trial, nearly 13% experienced reintubation. The main cause was difficulty in sputum excretion (66.7%).
