Could EtCO2 be higher than PaCO2 in a congenic heart diseased child?

21 September 2023 1 8K Report

Could be any scenario that you could find a higher EtCO2 than the value of a PCO2 of a ABG in a children with a congenic heart disease under invasive mechanical ventilation?

In my case, a patient of 8 days since birth after a surgery of transposition of great vessels in a neurocritical situation due to an acute brain bleeding is having an EtCO2 of 44 mmHg and a PaCO2 of 35 mmHg.

Alok Kumar Bharti

In normal healthy individuals, PaCO2 is 2-5 mmHg is higher than EtC02 While considering congenital heart disease, particularly R-L shunt, Pa C02 wil be too much higher than EtC02 or increased difference of PaC02-EtC02 and it's all because of Hypoperfusion of pulmonary circulation and alveolar hyperffysion . Reverse can be seen in L-R shunt where PaCO2 will be too low

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