Relationship between ETCO2 and PaCO2 in Ventilated Infants with NAVA

A recent study evaluated the validity of end-tidal CO2 (ETCO2) as a surrogate for arterial PCO2 (PaCO2) in infants on neurally adjusted ventilatory assist (NAVA), specifically considering the influence of variable spontaneous breathing on capnography waveforms. 

It enrolled 16 infants, analyzed 50 paired ETCO2 and PaCO2 values, and found-

• Stronger correlation for maximum ETCO2 than mean ETCO2 and a significantly weaker association for minimum ETCO2. 
• The superior predictive value of maximum ETCO2 in estimating PaCO2 highlights its reliable use in clinical monitoring, especially given the dynamic capnography associated with NAVA's variable pressures. 

These results underscore ETCO2's potential to enhance noninvasive respiratory management, reduce the frequency of blood sampling, and improve overall care for infants requiring mechanical ventilation.

Takahashi D, Goto K, Goto K. Relationship between ETCO2 and PaCO2 under Changing Capnogram in Ventilated Infants with NAVA: An Observational Study. Indian J Pediatr. 2024;91:1072–1074. https://doi.org/10.1007/s12098-023-04976-0