PAS 2026 Abstract Reports Association Between IVCO2 Index Implementation and Blood Gas Measurement Frequency in NICU Patients
Boston, Mass., April 27, 2026 – Etiometry announced that a retrospective analysis was presented at the Pediatric Academic Societies (PAS) 2026 Meeting, evaluating changes in blood gas measurement frequency following clinical adoption of its IVCO2 Index in a Level IV Neonatal Intensive Care Unit (NICU). Investigators compared outcomes before and after implementation and reported 10% fewer blood gas measurements per day in the post-implementation period, while the rate of clinically significant hypercapnia detection, as measured by blood gas analysis, remained unchanged.
Respiratory failure is a common reason for NICU admission. While oxygen levels can be continuously monitored using pulse oximetry, carbon dioxide (pCO2) monitoring remains challenging. Non-invasive monitoring methods can be inconsistent and, in some cases, pose risks of patient injury (e.g., skin burns from transcutaneous monitoring), leaving clinicians reliant on invasive blood sampling to detect hypercapnia, a process that is painful and carries its own procedural risks.
The study evaluated the impact of Etiometry’s IVCO2 Index, an FDA-cleared adjunctive index derived from routinely collected bedside physiologic data and laboratory measurements. The IVCO2 Index continuously tracks the likelihood that, if a blood gas were to be performed, the resulting PaCO2 would be above a defined threshold. An increasing IVCO2 Index can prompt clinical attention to the patient. The IVCO2 index provides partial quantitative information and should be interpreted alongside other clinical data. Researchers examined whether implementation of the algorithm was associated with changes in blood gas measurement testing while preserving the detection of clinically significant hypercapnia.
Investigators analyzed a retrospective cohort of 614 neonates, comparing outcomes before and after IVCO2 implementation. Despite the post-implementation group being more premature and requiring longer durations of mechanical ventilation, clinicians obtained 10% fewer blood gas measurements per day after adoption of the algorithm. Importantly, the rate of detected hypercapnia remained unchanged.
“These results suggest decision support may help clinicians be more targeted in their use of invasive testing,” said lead author Luke Viehl, MD, a neonatologist and assistant professor of pediatrics in the Division of Newborn Medicine at Washington University School of Medicine in St. Louis. “Reducing unnecessary blood gas draws may help lessen procedural burden in critically ill newborns.”
In addition to reduced testing frequency, the study found that respiratory severity scores and ventilator days were higher in the post-implementation cohort, underscoring that improvements occurred despite increased illness severity. Visual analyses showed a shift toward more targeted use of blood gases to evaluate elevated pCO2 levels following implementation, further supporting the algorithm’s clinical utility.
The authors note that the findings support further evaluation of decision-support approaches that may reduce procedural burden in NICU workflows. These findings are based on a retrospective analysis from a single center. Regulatory / Intended Use Note: The Etiometry Platform is not an active patient monitoring system. The IVCO2 Index is an adjunctive indicator; it provides partial quantitative information and must be interpreted with other clinical data. Do not use the index as a substitute for taking blood samples, and do not rely on the platform as the sole source of patient status information.
About Etiometry
Founded in 2010, Etiometry offers FDA-cleared critical care software that records and displays physiologic data from supported devices and calculates adjunctive indices intended to aid clinician review of patient status. By leveraging advanced analytics and AI-powered insights, the company supports care teams in identifying subtle changes in patient condition, enabling timely clinical decision-making and intervention.
Etiometry has received 11 FDA clearances and is trusted by leading healthcare institutions worldwide, including top-ranked academic medical centers and pediatric hospitals. The company is committed to advancing patient safety, improving clinical efficiency, and lowering the cost of care through smarter data utilization. To learn more, visit Etiometry.com.
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Bellmont Partners
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