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At least 955 records · Page 53Linked to original sources
PubMed2006

An evaluation of a transcutaneous and an end-tidal capnometer for noninvasive monitoring of spontaneously breathing patients.

BACKGROUND: Since there is a growing use of analgesia and sedation in spontaneously breathing patients undergoing diagnostic or therapeutic interventions, recommendations by national societies of anesthesiologists call for the application of capnometry during all anesthetic procedures. METHODS: We compared readings from a transcutaneous capnometer (Tosca) and an end-tidal capnometer (Microcap Plus) to P(aCO2) measurements made via arterial-blood-gas analysis. We studied 30 spontaneously breathing patients who were recovering from general anesthesia, and we used Bland Altman analysis to compare the capnometry readings to the arterial-blood-gas values. Expiratory gas samples for end-tidal capnometry were taken either from a conventional face mask or an oral/nasal cannula. RESULTS: The Tosca significantly overestimates P(aCO2) (mean +/- SD difference 5.6 + 3.4 mm Hg). The Microcap Plus significantly underestimates P(aCO2) (mean +/- SD difference -14.1 +/- 7.4 mm Hg). There was no significant difference between the face mask and oral/nasal cannula with regard to collecting end-tidal samples. CONCLUSION: Both the Tosca and Microcap Plus provide just an approximate estimation of P(aCO2). Clinical use of these monitors can not be proposed under actual conditions but will be advantageous after correction of the limiting errors.

Aged↗
PubMed2006

[Evaluation of a compact device for capnometry of main-stream type compared with one of side-stream type in a postoperative care unit].

BACKGROUND: Pulse oximetry is insufficient for postoperative respiratory monitoring. It is better to use capnometry for postoperative patients because it is easy to use and useful to monitor patients' breathing. However, capnometry must be improved in its wearability and detection capability. Therefore it is not used often for postoperative patients as a respiratory monitor. METHODS: We have examined a side-stream type capnometer and an improved main-stream type capnometer in a post-anesthesia care unit (PACU) to determine which is better as a monitor for detection of breathing. A total of 55 patients participated in this study. Patients wore a device including a main-stream capnometer and a side-stream capnometer. Capnograms were recorded while patients were staying in the PACU. RESULTS: The main-stream system could detect breathing in all the patients, but the side-stream system failed to detect breathing in five patients. The side-stream device showed a warning of "apnea" for five patients, even though these patients were breathing normally. CONCLUSIONS: We conclude that the main-stream system is a better monitor of postoperative respiratory condition.

Capnography↗
PubMedDate not supplied

[The laryngeal mask in pediatric anesthesia].

AIM. To evaluate the validity of general anesthesia using the laryngeal mask airway (LMA) in pediatrics in a series of 163 patients. MONITORING. ETCO2 and SpO2 were evaluated five minutes after the insertion of LMA and then at five minute intervals. SpO2 was evaluated every two minutes after the removal of LMA. Use of occasional arterial blood-gas analysis. EVALUATION OF QUALITY OF ANESTHESIA AND VENTILATION. Measurement of every complication during and after anesthesia. CONCLUSIONS. In pediatric anesthesia LMA represents a good link between anesthetic equipment and the patient.

Anesthesia, General↗
PubMed1996

[Monitoring of emergency and intensive care patients: simple diagnostic aids].

This article describes in short sections the use and interpretation of indirect blood pressure measurements, central venous pressure, body temperature, pulse oximetry, end tidal CO2 measurements, pulse and heart rate, urine production and emergency laboratory values. Most of these parameters are directly or indirectly linked to the perfusion of the patient. Optimizing these values are one of the most important goals in emergency and critical care medicine.

Animals↗
PubMed1998

Monitoring adequacy of ventilation by capnometry during thoracotomy in dogs.

OBJECTIVE: To determine whether end-tidal partial pressure of carbon dioxide (PETCO2) was a reliable estimate of PaCO2 in dogs undergoing thoracotomy. DESIGN: Case series. ANIMALS: 18 dogs that underwent thoracotomy. PROCEDURE: PaCO2 and PETCO2 were measured shortly after induction of anesthesia, while dogs were breathing spontaneously; 5 minutes prior to initial skin incision, while dogs were receiving intermittent positive-pressure ventilation (IPPV); 5, 30, and 60 minutes after the thoracic cavity was opened, while dogs were receiving IPPV; and after the thoracic cavity was closed and evacuated, when dogs were again breathing spontaneously. For each period, arterial-end-tidal difference in partial pressure of carbon dioxide (PaCO2-PETCO2) was compared with PaCO2-PETCO2 for the preceding period. RESULTS: Significant changes in PaCO2-PETCO2 from one period to the next were not detected except when values obtained 5 minutes after the thoracic cavity was opened were compared with values obtained 5 minutes before incision. The PaCO2-PETCO2 was not constant for individual dogs. CLINICAL IMPLICATIONS: PETCO2 was not a reliable indicator of adequacy of ventilation during thoracotomy in these dogs, because it differed greatly from PaCO2, and PaCO2-PETCO2 was not consistent.

Animals↗
PubMed1997

Is measurement of end-tidal CO2 through a nasal cannula reliable?

When using a nasal cannula to sample gases expired by a patient, air from the room may dilute the sample. For this reason, the accuracy of the partial pressure of end-tidal carbon dioxide (ETCO2) measurements is questionable. We experimentally examined the reliability of ETCO2 measurements through a nasal cannula and found that they depended on both biological factors (tidal volume and respiratory rates) and mechanical factors (the diameter and the length of the cannula and the diameter of the prongs). These results suggest that the correct use of an appropriate sampling cannula will provide reliable ETCO2 measurements without clinical problems.

Capnography↗
PubMedDate not supplied

[Pulse oximetry and capnometry in the prevention of perioperative morbidity and mortality].

Oxygen saturation (SaO2) and end tidal CO2 determined by pulse oximetry and capnometry were monitored in 2440 surgical patients during elective head and neck, abdominal, traumatologic and orthopedic surgery. The incidence, severity and duration of hypoxemia and hypercarbia were studied as well as their causes. Equipment disconnections alarmed by capnometry were noted separately. Hypoxemia was defined as SaO2 < or = 90% and graded into three values of SaO2 and hypercarbia was defined as EtCO2 > or = 50 mmHg. Severe hypoxemia (SaO2 < or = 80%) occurred in 170 (8%) patients. A greater number of severe events occurred in children under 2 yr of age (p < 0.02). The pulse oximeter diagnosed hypoxemia before the signs and symptoms of hypoxemia were apparent (cyanosis or bradycardia). Severe hypoxemic episodes were unrelated to the duration of anesthesia. Equipment disconnections alarmed by capnometer were most frequent in head and neck surgery (p < 0.02). Capnometer alarmed disconnections before the signs of hypoxemia and hypercarbia occurred. No morbidity was documented in any patients who suffered an hypoxemia event. Pulse oximetry and capnometry enable early detection and removal of the majority of the ventilation mishaps before damage or even death occur.

Adolescent↗
PubMed1998

Utilization of intensive care unit technology.

Technology utilization in acute and critical care holds great promise for improving the management and outcome of patients. However, before this promise can be realized, technology has to be properly evaluated for appropriateness of use. This evaluation must include both the clinical impact on patient outcomes as well as the economic impact. Following this initial evaluation, for technologies deemed appropriate for use, careful preparation of clinicians in the use of the technology is necessary. Education must prioritize how the technology is to be used as well as provide incentives for the clinicians to change their current practice. If these three key steps are followed, technology can achieve the promise of improving patient management and outcome. Unfortunately, evidence exists which suggests that these three steps are not followed in many, if not most, hospitals in the United States. In this article, a method of implementing these three steps is presented. However, it is essential that national organizations and societies become active in this process, lest widespread variation in technology utilization continue.

Attitude of Health Personnel↗
PubMed1997

Considerations for developing a clinical capnogram monitoring system.

Clinical monitoring and diagnostic systems may require the analysis of multiple physiologic signals to generate a diagnosis. The complexity of these systems is formidable for at least two reasons: clinical physiologic signals are noisy, and systems built around multiple signals may fail when any single signal is absent. In view of these limitations, we have been developing a clinical respiratory CO2 waveform (capnogram) diagnostic system. The purpose of this system is to develop a differential diagnosis from a single signal for subsequent evaluation within the context of multiple single-signals. This paper will review the development issues which we have been confronting, and discuss the tools and methods which have been successful.

Adult↗