https://scholars.lib.ntu.edu.tw/handle/123456789/637835
Title: | Blood gas, arterial, and end-tidal carbon dioxide in traumatic brain injury | Authors: | Yang, Jen Ting CHUN-YU WU Wright, David R. |
Keywords: | Brain Trauma Foundation guidelines | Cerebral blood flow regulation | Cerebrovascular CO reactivity 2 | End-tidal carbon dioxide (EtCO ) monitoring 2 | PaCO -EtCO agreement 2 2 | PaCO -EtCO correlation 2 2 | Pre-hospital management | Transcutaneous partial pressure of carbon dioxide (PtcCO ) monitoring 2 | Traumatic brain injury | Issue Date: | 1-Jan-2022 | Source: | Cellular, Molecular, Physiological, and Behavioral Aspects of Traumatic Brain Injury | Abstract: | Managing arterial partial pressure of carbon dioxide (PaCO2) is a critical component in severe traumatic brain injury (TBI) care; current guidelines recommend maintaining normoventilation (PaCO2 35-45mmHg) and advise against prolonged prophylactic hyperventilation except for reversing brain herniation. While arterial blood sampling remains the gold standard, end-tidal carbon dioxide (EtCO2) monitoring is a noninvasive surrogate measurement used to estimate PaCO2 values. In acute TBI care setting, data generally showed only moderate correlation between PaCO2 and EtCO2 and agreement < 50% (defined as PaCO2-EtCO2 ≤ 5 or 6mmHg). Several concurrent conditions leading to V/Q mismatching were identified to further undermine the reliability of EtCO2 as a PaCO2 surrogate, such as severe chest trauma, hypotension, and pediatric acute respiratory distress syndrome. Transcutaneous partial pressure of carbon dioxide (PtcCO2) monitoring is another proposed surrogate for PaCO2; its application in adult severe TBI did not show superiority over EtCO2 monitoring. More research is warranted to evaluate the utility of PtcCO2 monitoring in severe TBI care. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/637835 | ISBN: | 9780128230367 | DOI: | 10.1016/B978-0-12-823036-7.00002-5 |
Appears in Collections: | 醫學系 |
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