Capnography for diagnosing DKA?

13 Jan

Interesting article from Iran:

181 adult patients, 62 had DKA

  • included: patients attendings had clinical suspicion for DKA, BG >250
  • excluded: pts likely to have metabolic disturbances (e.g. gastroenteritis, chronic renal failure, respiratory dz, ALOC, etc).

capnography > 24.5 mmHg had sensitivity & specificity of 90%

excludes a lot, but interesting

peds study from Austrailia had a similar idea:

58 kids, 15 had DKA

No patients with an ETCO(2) > 30 mmHg had DKA (sensitivity 1.0, specificity 0.86).

6 patients with an ETCO(2) < 30 mmHg did not have DKA.

BOTTOM LINE:

some small studies with some limitations, but food for thought

in a pinch, capnography would be a quick bit of info on potential acidosis (using respiratory compensation with ETCO2 as the sideways look).  

References: adult article; peds article; picture

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