What’s the Latest on Carbon Dioxide Monitoring?

CARBON DIOXIDE (CO2) monitoring is a mainstay of evaluation for any patient with a respiratory problem. Although CO2 monitoring is not a new modality, it is continuously changing as new methods are developed. The gold standard of carbon dioxide monitoring is measurement of PCO2 obtained as part of the arterial blood gas. Although this is the most accurate way to monitor the amount of CO2 in the blood, it is also the most costly to the neonate because it requires a blood sample. Neonatal care practitioners strive to minimize blood losses in order to reduce the need for blood transfusions. In addition, arterial blood gas monitoring is not always practical, because the time and equipment to obtain and run a sample are not always available, particularly in the delivery room or during transport. Another drawback to arterial blood gas monitoring is that it requires either the placement of a central line or an arterial puncture. As caregivers concerned with pain in the neonate, we strive to minimize the number of painful procedures our patients experience. Central lines may increase the risk of infections, a constant concern with the emergence of resistant organisms in our nurseries. For these reasons, noninvasive forms of carbon dioxide monitoring are on the forefront of neonatal care.