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Original Research 
RMJ. 2026; 51(2): 468-471


Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan

Rana Tashfeen Arshad, Abdur Rehman, Nazia Fatima, Muhammad Akram, Muhammad Zahid, Tajwar Khan.


Abstract
Objective: To evaluate the correlation between end-tidal carbon dioxide (ETCO2) and arterial carbon dioxide (PaCO2) in ventilated neonates at NICU.
Methodology: This prospective observational study included 111 neonates receiving mechanical ventilation at the NICU, Children Hospital, Multan, from March to August 2025. Neonates aged ≤28 days, of either gender or any gestational age, were enrolled after informed consent. Consecutive sampling was used. Simultaneous capnography (ETCO₂) and PaCO₂ were recorded at 1- and 12-hours post-ventilation (mean values considered). Data were analyzed using IBM SPSS 26.0; normality was tested, quantitative data summarized appropriately, and correlation/agreement between ETCO₂ and PaCO₂ assessed using Pearson’s r and Bland-Altman plots.
Results: Out of 111 neonates, 64 (57.7%) were male, while the median age was 6.0 days, and the mean birth weight was 2.4±0.5 kg. Preterm infants were 78 (70.3%) cases. Mean PaCO₂ was 43.7±7.3 mmHg, and mean ETCO₂ was 40.8±9.2 mmHg. Mean arterial pH, HCO₃⁻, base excess, and lactate were 7.3±0.1, 20.8±3.1 mmol/L, –4.2±2.7 mmol/L, and 2.8±1.1 mmol/L, respectively. A strong correlation was found (r=0.750, p<0.001), with Bland-Altman analysis showing a mean bias of 2.91 mmHg.
Conclusion: ETCO₂ demonstrates a strong and clinically meaningful correlation and agreement with PaCO₂ in ventilated neonates.

Key words: Capnography, ETCO₂, neoante, NICU, PaCO₂, preterm.


 
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How to Cite this Article
Pubmed Style

Arshad RT, Rehman A, Fatima N, Akram M, Zahid M, Khan T. Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan. RMJ. 2026; 51(2): 468-471.

Web Style

Arshad RT, Rehman A, Fatima N, Akram M, Zahid M, Khan T. Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan. https://www.rmj.org.pk/?mno=283446 [Access: June 22, 2026].

AMA (American Medical Association) Style

Arshad RT, Rehman A, Fatima N, Akram M, Zahid M, Khan T. Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan. RMJ. 2026; 51(2): 468-471.


Vancouver/ICMJE Style

Arshad RT, Rehman A, Fatima N, Akram M, Zahid M, Khan T. Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan. RMJ. (2026), [cited June 22, 2026]; 51(2): 468-471.


Harvard Style

Arshad, R. T., Rehman, . A., Fatima, . N., Akram, . M., Zahid, . M. & Khan, . T. (2026) Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan. RMJ, 51 (2), 468-471.


Turabian Style

Arshad, Rana Tashfeen, Abdur Rehman, Nazia Fatima, Muhammad Akram, Muhammad Zahid, and Tajwar Khan. 2026. Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan. Rawal Medical Journal, 51 (2), 468-471.


Chicago Style

Arshad, Rana Tashfeen, Abdur Rehman, Nazia Fatima, Muhammad Akram, Muhammad Zahid, and Tajwar Khan. "Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan." Rawal Medical Journal 51 (2026), 468-471.


MLA (The Modern Language Association) Style

Arshad, Rana Tashfeen, Abdur Rehman, Nazia Fatima, Muhammad Akram, Muhammad Zahid, and Tajwar Khan. "Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan." Rawal Medical Journal 51.2 (2026), 468-471. Print.


APA (American Psychological Association) Style

Arshad, R. T., Rehman, . A., Fatima, . N., Akram, . M., Zahid, . M. & Khan, . T. (2026) Is end-tidal CO2 as accurate as the PaCO2 in ventilated neonates: A study at NICU of Children Hospital, Multan, Pakistan. Rawal Medical Journal, 51 (2), 468-471.


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