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Capnography monitoring

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https://www.readbyqxmd.com/read/28509772/safety-of-deep-sedation-in-the-endoscopy-suite
#1
Megan L Allen
PURPOSE OF REVIEW: As the complexity of endoscopic procedures increases, the use of propofol and the desire for deep sedation are becoming more common in the endoscopy suite. This review explores sedation depth, agents used for sedation, recommended monitoring, and adverse event risks that occur during sedation for endoscopy. RECENT FINDINGS: The sedation provider for endoscopy varies by practice location and with regulatory requirements. As increasingly deep levels of sedation are used in this setting, the need for all providers to have training in the ability to rescue patients from sedation-related side effects is paramount...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28499516/improving-cpr-performance
#2
REVIEW
Boulos S Nassar, Richard Kerber
Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Key steps health care systems can take to enhance the quality of CPR and, potentially, to improve outcomes, include optimizing chest compressions; avoiding hyperventilation; encouraging intraosseus access, and monitoring capnography...
May 9, 2017: Chest
https://www.readbyqxmd.com/read/28475040/model-based-estimation-of-respiratory-parameters-from-capnography-with-application-to-diagnosing-obstructive-lung-disease
#3
Abubakar Abid, Rebecca J Mieloszyk, George C Verghese, Baruch S Krauss, Thomas Heldt
OBJECTIVE: We use a single-alveolar-compartment model to describe the partial pressure of carbon dioxide in exhaled breath, as recorded in time-based capnography. Respiratory parameters are estimated using this model and then related to the clinical status of patients with obstructive lung disease. METHODS: Given appropriate assumptions, we derive an analytical solution of the model, describing the exhalation segment of the capnogram. This solution is parametrized by alveolar CO2 concentration, dead-space fraction, and the time constant associated with exhalation...
May 2, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28472554/efficacy-of-intravenous-cobinamide-versus-hydroxocobalamin-or-saline-for-treatment-of-severe-hydrogen-sulfide-toxicity-in-a-swine-sus-scrofa-model
#4
Vikhyat S Bebarta, Normalynn Garrett, Matthew Brenner, Sari Mahon, Joseph K Maddry, Susan Boudreau, Maria Castaneda, Gerard Boss
BACKGROUND: Hydrogen sulfide (H2S) is a potentially deadly gas that naturally occurs in petroleum and natural gas. The Occupational Health and Safety Administration cites H2S as a leading cause of workplace gas inhalation deaths. Mass casualties of H2S toxicity may be caused by exposure from industrial accidents or release from oil field sites. H2S is also an attractive terrorism tool because of its high toxicity and ease with which it can be produced. Several potential antidotes have been proposed for hydrogen sulfide poisoning but none have been completely successful...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28460704/continuous-capnography-in-pediatric-intensive-care
#5
REVIEW
Christine M Riley
Capnography or end-tidal carbon dioxide (Etco2) monitoring has a variety of uses in the pediatric intensive care setting. The ability to continuously measure exhaled carbon dioxide can provide vital information about airway, breathing, and circulation in critically ill pediatric patients. Capnography has diagnosis-specific applications for pediatric patients with congenital heart disease, reactive airway disease, neurologic emergencies, and metabolic derangement. This modality allows for noninvasive monitoring and has become the standard of care...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28448390/comparison-of-postoperative-respiratory-monitoring-by-acoustic-and-transthoracic-impedance-technologies-in-pediatric-patients-at-risk-of-respiratory-depression
#6
Mario Patino, Megan Kalin, Allison Griffin, Abu Minhajuddin, Lili Ding, Timothy Williams, Stacey Ishman, Mohamed Mahmoud, C Dean Kurth, Peter Szmuk
BACKGROUND: In children, postoperative respiratory rate (RR) monitoring by transthoracic impedance (TI), capnography, and manual counting has limitations. The rainbow acoustic monitor (RAM) measures continuous RR noninvasively by a different methodology. Our primary aim was to compare the degree of agreement and accuracy of RR measurements as determined by RAM and TI to that of manual counting. Secondary aims include tolerance and analysis of alarm events. METHODS: Sixty-two children (2-16 years old) were admitted after tonsillectomy or receiving postoperative patient/parental-controlled analgesia...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28413621/recent-advances-in-pediatric-ventilatory-assistance
#7
REVIEW
Nicolas Nardi, Guillaume Mortamet, Laurence Ducharme-Crevier, Guillaume Emeriaud, Philippe Jouvet
In this review on respiratory assistance, we aim to discuss the following recent advances: the optimization and customization of mechanical ventilation, the use of high-frequency oscillatory ventilation, and the role of noninvasive ventilation. The prevention of ventilator-induced lung injury and diaphragmatic dysfunction is now a key aspect in the management of mechanical ventilation, since these complications may lead to higher mortality and prolonged length of stay in intensive care units. Different physiological measurements, such as esophageal pressure, electrical activity of the diaphragm, and volumetric capnography, may be useful objective tools to help guide ventilator assistance...
2017: F1000Research
https://www.readbyqxmd.com/read/28339316/practical-insight-to-monitor-home-niv-in-copd-patients
#8
Jean-Michel Arnal, Joëlle Texereau, Aude Garnero
Home noninvasive ventilation (NIV) is used in COPD patients with concomitant chronic hypercapnic respiratory failure in order to correct nocturnal hypoventilation and improve sleep quality, quality of life, and survival. Monitoring of home NIV is needed to assess the effectiveness of ventilation and adherence to therapy, resolve potential adverse effects, reinforce patient knowledge, provide maintenance of the equipment, and readjust the ventilator settings according to the changing condition of the patient...
March 24, 2017: COPD
https://www.readbyqxmd.com/read/28337439/a-brief-review-of-non-invasive-monitoring-of-respiratory-condition-for-extubated-patients-with-or-at-risk-for-obstructive-sleep-apnea-after-surgery
#9
REVIEW
Xuezheng Zhang, Mahmoud Attia Mohamed Kassem, Ying Zhou, Muhammad Shabsigh, Quanguang Wang, Xuzhong Xu
Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28334427/capnography-versus-standard-monitoring-for-emergency-department-procedural-sedation-and-analgesia
#10
REVIEW
Brian F Wall, Kirk Magee, Samuel G Campbell, Peter J Zed
BACKGROUND: Procedural sedation and analgesia (PSA) is used frequently in the emergency department (ED) to facilitate painful procedures and interventions. Capnography, a monitoring modality widely used in operating room and endoscopy suite settings, is being used more frequently in the ED setting with the goal of reducing cardiopulmonary adverse events. As opposed to settings outside the ED, there is currently no consensus on whether the addition of capnography to standard monitoring modalities reduces adverse events in the ED setting...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28314626/cerebral-hemodynamic-effects-of-cheyne-stokes-respiration-in-a-patient-with-stroke
#11
R C Nogueira, R B Panerai, M J Teixeira, T G Robinson, E Bor-Seng-Shu
INTRODUCTION: Cheyne-Stokes respiration (CSR) and central sleep apnea (CSA) are common in patients with heart failure and/or stroke. We aim to describe the cerebrovascular effects of CSR during the acute phase of stroke in a heart failure patient. CASE REPORT: A 74-year-old male with previous dilated cardiomyopathy had sudden onset of right hemiparesis and aphasia. A transcranial Doppler was performed with continuous measurement of blood pressure (BP) (Finometer) and end-tidal CO2 (nasal capnography)...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28288298/detection-of-respiratory-adverse-events-in-pediatric-dental-patients-sedated-with-0-75mg-kg-of-midazolam-and-oxygen-by-continuous-pretracheal-auscultation-a-prospective-randomized-controlled-trial
#12
Mostafa Somri, Ibrahim Matter, Christopher Hadjittofi, Naser Hoash, Bian Moaddi, Johnny Kharouba, Constantinos A Parisinos, Benjamin Peretz
PURPOSE: Sedation is becoming more commonplace for pediatric patients undergoing minor procedures. Fortunately, electronic monitors have contributed to a reduction in the associated respiratory adverse events (RAEs). To test the hypothesis that adding the pretracheal stethoscope (PTS) to standard monitoring methods (SMMs) may improve RAE detection in sedated pediatric dental patients, the frequency of RAEs detected by SMMs (i.e. visual observation, capnography, and pulse oximetry) was compared to that detected by SMMs alongside continuous PTS auscultation...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28269218/a-pulse-transit-time-based-fusion-method-for-the-noninvasive-and-continuous-monitoring-of-respiratory-rate
#13
Xiao-Rong Ding, Yuan-Ting Zhang, Hon Ki Tsang, Walter Karlen
The purpose of this study was to investigate whether pulse transit time (PTT) can be used for continuous monitoring of respiratory rate (RR). We derived PTT from the electrocardiogram and photoplethysmogram obtained from 42 recordings of CapnoBase, a publicly available benchmark data set for validating respiratory related measurements. The number of breaths in a minute (RR#) was estimated from the heart rate interval (HRI), pulse rate interval (PRI), and from PTT. In addition, to improve the estimation reliability, we investigated a fusion of the three HRI, PRI and PTT derived estimations...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28244630/implementation-of-nap4-emergency-airway-management-recommendations-in-a-quaternary-level-pediatric-hospital
#14
Elliot Long, Domenic Cincotta, Joanne Grindlay, Anastasia Pellicano, Michael Clifford, Stefan Sabato
Emergency airway management, particularly outside of the operating room, is associated with a high incidence of life-threatening adverse events. Based on the recommendations of the 4th National Audit Project, we aimed to develop hospital-wide systems changes to improve the safety of emergency airway management. We describe a framework for governance in the form of a hospital airway special interest group. We describe the development and implementation of the following systems changes: 1. A local intubation algorithm modified from the Difficult Airway Society's plan A-B-C-D approach, including clear pathways for airway escalation, and emphasizing the concepts of resuscitation prior to intubation, planning for failure, and avoidance of fixation error...
February 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28229352/linshom-thermodynamic-sensor-is-a-reliable-alternative-to-capnography-for-monitoring-respiratory-rate
#15
David Preiss, Benjamin A Drew, James Gosnell, Bhavani S Kodali, James H Philip, Richard D Urman
Monitoring ventilation accurately is a technically challenging, yet indispensable aspect of patient care in the intra- and post-procedural settings. A new prototypical device known as the Linshom Respiratory Monitoring Device (LRMD) has been recently designed to non-invasively, inexpensively, and portably measure respiratory rate. The purpose of this study was to measure the accuracy and variability of LRMD measurements of respiratory rate relative to the measurement of capnography. In this prospective study, participants were enrolled and individually fitted with a face mask monitored by the LRMD and capnography...
February 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28227448/a-pulse-transit-time-based-fusion-method-for-the-noninvasive-and-continuous-monitoring-of-respiratory-rate
#16
Xiao-Rong Ding, Yuan-Ting Zhang, Hon Ki Tsang, Walter Karlen, Xiao-Rong Ding, Yuan-Ting Zhang, Hon Ki Tsang, Walter Karlen, Hon Ki Tsang, Walter Karlen, Yuan-Ting Zhang, Xiao-Rong Ding
The purpose of this study was to investigate whether pulse transit time (PTT) can be used for continuous monitoring of respiratory rate (RR). We derived PTT from the electrocardiogram and photoplethysmogram obtained from 42 recordings of CapnoBase, a publicly available benchmark data set for validating respiratory related measurements. The number of breaths in a minute (RR#) was estimated from the heart rate interval (HRI), pulse rate interval (PRI), and from PTT. In addition, to improve the estimation reliability, we investigated a fusion of the three HRI, PRI and PTT derived estimations...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223465/assessment-of-bohr-and-enghoff-dead-space-equations-in-mechanically-ventilated-children
#17
Pierre Bourgoin, Florent Baudin, David Brossier, Guillaume Emeriaud, Marc Wysocki, Philippe Jouvet
BACKGROUND: Recent findings suggest that using alveolar PCO2 (PACO2 ) estimated by volumetric capnography in the Bohr equation instead of PaCO2 (Enghoff modification) could be appropriate for the calculation of physiological dead space to tidal volume ratio (VD/VT Bohr and VD/VT Enghoff, respectively). We aimed to describe the relationship between these 2 measurements in mechanically ventilated children and their significance in cases of ARDS. METHODS: From June 2013 to December 2013, mechanically ventilated children with various respiratory conditions were included in this study...
April 2017: Respiratory Care
https://www.readbyqxmd.com/read/28202085/should-capnography-be-used-as-a-guide-for-choosing-a-ventilation-strategy-in-circulatory-shock-caused-by-severe-hypothermia-observational-case-series-study
#18
Tomasz Darocha, Sylweriusz Kosiński, Anna Jarosz, Paweł Podsiadło, Mirosław Ziętkiewicz, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia can cause circulatory disturbances ranging from cardiac arrhythmias through circulatory shock to cardiac arrest. Severity of shock, pulmonary hypoperfusion and ventilation-perfusion mismatch are reflected by a discrepancy between measurements of CO2 levels in end-tidal air (EtCO2) and partial CO2 pressure in arterial blood (PaCO2). This disparity can pose a problem in the choice of an optimal ventilation strategy for accidental hypothermia victims, particularly in the prehospital period...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28177565/the-impact-of-capnography-monitoring-among-children-and-adolescents-in-the-postanesthesia-care-unit-a-randomized-controlled-trial
#19
Melissa L Langhan, Fang-Yong Li, J Lance Lichtor
BACKGROUND: Pulse oximetry does not reliably recognize respiratory depression, particularly in the presence of supplemental oxygen. Capnography frequently detects hypoventilation and apnea among children recovering from anesthesia. Although children are routinely monitored with capnography during anesthesia, reducing the rate of adverse events, it is not routinely used in the postanesthesia care unit (PACU), where patients remain at risk for respiratory depression. AIM: We hypothesized that children monitored with capnography would have more frequent staff interventions and fewer adverse events than children monitored with pulse oximetry alone...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#20
Praveen Chandrasekharan, Payam Vali, Munmun Rawat, Bobby Mathew, Sylvia F Gugino, Carmon Koenigschnekt, Justin Helman, Jayasree Nair, Sara Berkelhamer, Satyan Lakshminrusimha
BACKGROUND: In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2) or SpO2 to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS: We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n=21). Lambs were resuscitated as per NRP guidelines...
February 3, 2017: Pediatric Research
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