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PubMed1990

Capnography.

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Carbon Dioxide↗
PubMed1994

Alpha-stat capnography for the Sorin Monolyth oxygenator.

Monitoring the carbon dioxide exhaust of an oxygenator is an inexpensive method to accurately predict and control the arterial carbon dioxide tension during cardiopulmonary bypass (CPB). The partial pressure of carbon dioxide in the exhaust ventilating gas (p exCO 2) was continuously monitored from the capnograph port of the Sorin Monolyth oxygenator during CPB. At the time of routine arterial blood gas sampling, the arterial blood temperature (ABT) was recorded along with the p exCO 2 from the capnograph monitor. The arterial carbon dioxide tension (paCO 2) from the arterial blood sample analysis was then statistically analyzed and related to the p exCO 2 and ABT. The statistical relationship of p exCO 2 and ABT while employing alpha stat ventilation resulted in an exponential regression with a correlation coefficient of 0.98. The exponential regression is unique to each manufacturer's oxygenator; we have titled this the "regression signature." This regression signature can be easily learned and employed by the perfusionist during CPB as an aid in controlling oxygenator ventilation. The mean paCO 2 value obtained during the study period was 39.0 +/-2.5 mmHg. There was no statistical difference between the paCO 2 values when separated into four different blood temperature groups, ( less than 28, 28-32, 32-37, and greater than 37 degrees C).

Carbon Dioxide↗
PubMed1975

Capnography: a sensitive method of early detection of air embolism.

Seven capnograms are shown demonstrating the invariable fall in the level of expired CO2 which occurs during the operation for the insertion of a Pudenz-Heyer drain for hydrocephalus. The fall occurs when contrast medium is injected down the heart catheter after withdrawal of the guide but never after subsequent injections unless air is present in the syringe. The effect is shown not to be due to a difference in temperature between the contrast medium and the body. A comparison is made with a capnogram recorded during the setting up of an I.V. transfusion in an infant in which a small quantity of air was seen to enter the circulation along the tubing of the butterfly needle. It is concluded that the fall in the capnogram seen during Pudenz-Heyer operations is due to air embolism. The severity of its effect is shown to be proportional to the volume of air injected in relation to body weight. The value of the capnograph as a sensitive monitor of air embolism is emphasised together with the fact that the fall in the capnogram precedes that of the blood pressure or any other recordable effect.

Carbon Dioxide↗
PubMed1991

[Capnography].

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Blood Gas Analysis↗
PubMed1991

[Capnometry and capnography as safety factors in anesthesia].

Continuous measurement and monitoring of the expiratory carbon dioxide concentration can be performed with modern measurement devices routinely without any problem today. After a short introduction to measurement techniques the comprehensive monitoring possibilities of this method are described by multiple examples. No only actual disturbances of the ventilation, the circulation and the metabolism, but also malfunction or inadequate control of the anaesthesia machine can be recognized without substantial time delay. But an actual alteration of the CO2 value necessitates careful analysis of the underlying problem which is greatly facilitated by a graphic display of the CO2 signal, the capnogram. The knowledge of possibly occurring artificial alterations of the CO2 measurement, which are demonstrated too, prevents dangerous misinterpretations. By continuous measurement of the expiratory CO2 concentration, not only can the ventilation parameters be set optimally, but multiple life threatening complications can be detected very early and corrected immediately. Thus, this monitoring technique essentially contributes to the patients safety during anaesthesia.

Anesthesia↗