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Capnography monitoring

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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
#1
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
#2
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...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#3
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
https://www.readbyqxmd.com/read/28123650/post-operative-capnostream-monitoring-in-patients-with-obstructive-sleep-apnoea-symptoms-case-series
#4
Vasanth Rao Kadam, Mazyar Danesh
Obstructive sleep apnoea (OSA) patients on opioid analgesic have an increased incidence of postoperative respiratory complications; prevention of these may be possible with appropriate post-operative monitoring. We recruited 4 OSA patients who had general anaesthesia for orthopaedic and septoplasty surgery. They required Patient Controlled Analgesia (PCA) or oral opioids in the post-operative period, hence continuous Saturation of Oxygen (Spo2), End Tidal Carbon dioxide (EtCo2) monitoring on Capnostream monitor with Integrated Pulmonary Index (IPI) was organized in high dependency unit...
July 2016: Sleep Science
https://www.readbyqxmd.com/read/28099286/multicenter-study-validating-accuracy-of-a-continuous-respiratory-rate-measurement-derived-from-pulse-oximetry-a-comparison-with-capnography
#5
Sergio D Bergese, Michael L Mestek, Scott D Kelley, Robert McIntyre, Alberto A Uribe, Rakesh Sethi, James N Watson, Paul S Addison
BACKGROUND: Intermittent measurement of respiratory rate via observation is routine in many patient care settings. This approach has several inherent limitations that diminish the clinical utility of these measurements because it is intermittent, susceptible to human error, and requires clinical resources. As an alternative, a software application that derives continuous respiratory rate measurement from a standard pulse oximeter has been developed. We sought to determine the performance characteristics of this new technology by comparison with clinician-reviewed capnography waveforms in both healthy subjects and hospitalized patients in a low-acuity care setting...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28076483/sedation-in-colonoscopy-by-using-three-different-propofol-infusion-methods-and-analysis-of-plasma-concentration-levels-a-prospective-comparative-study
#6
Paulo Henrique Boaventura de Carvalho, José Pinhata Otoch, Mohamad Ali Khan, Paulo Sakai, Hugo Gonçalo Guedes, Everson Luiz de Almeida Artifon
Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients. Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies. Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28061836/end-tidal-capnographic-monitoring-to-detect-apnea-episodes-during-flexible-bronchoscopy-under-sedation
#7
Tsukasa Ishiwata, Kenji Tsushima, Mai Fujie, Kenichi Suzuki, Kosuke Hirota, Mitsuhiro Abe, Naoko Kawata, Jiro Terada, Koichiro Tatsumi
BACKGROUND: Apnea developing as a result of oversedation is a potential clinical problem in patients undergoing flexible bronchoscopy (FB) under sedation. However, there are no reports of evaluation using a standardized method of the frequency of occurrence of apnea episodes during FB under sedation. The aim of this study was to investigate the frequency of apnea episodes during FB under sedation in the clinical setting by end-tidal capnography. METHODS: This study was a single-institution retrospective review of a prospectively maintained database and medical records, including capnographic data, from April 2015 to March 2016...
January 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28032265/using-continuous-quantitative-capnography-for-emergency-department-procedural-sedation-a-systematic-review-and-cost-effectiveness-analysis
#8
Nicholas Matthew Mohr, Andrew Stoltze, Azeemuddin Ahmed, Elizabeth Kiscaden, Dan Shane
End-tidal CO2 has been advocated to improve safety of emergency department (ED) procedural sedation by decreasing hypoxia and catastrophic outcomes. This study aimed to estimate the cost-effectiveness of routine use of continuous waveform quantitative end-tidal CO2 monitoring for ED procedural sedation in prevention of catastrophic events. Markov modeling was used to perform cost-effectiveness analysis to estimate societal costs per prevented catastrophic event (death or hypoxic brain injury) during routine ED procedural sedation...
December 28, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28003557/comparing-the-effects-of-two-different-levels-of-hyperoxygenation-on-gas-exchange-during-open-endotracheal-suctioning-a-randomized-crossover-study
#9
Jacqueline Rodrigues de Freitas Vianna, Valéria Amorim Pires Di Lorenzo, Miléa Mara Lourenço da Silva Simões, Maurício Jamami
BACKGROUND: Endotracheal suctioning is required for mechanically ventilated patients to maintain a patent airway. Studies show that open endotracheal suctioning affects respiratory mechanics and gas exchange. The aim of this study was to compare the effectiveness of hyperoxygenation with FIO2 + 0.20 above baseline and hyperoxygenation with FIO2 1.0 in preventing hypoxemia, and to determine the impact of open endotracheal suctioning on the pulmonary ventilation of critical subjects receiving mechanical ventilatory support...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/28003555/redesign-of-an-open-system-oxygen-face-mask-with-mainstream-capnometer-for-children
#10
Natalie Napolitano, Akira Nishisaki, Hayley S Buffman, Jessica Leffelman, Matthew R Maltese, Vinay M Nadkarni
BACKGROUND: Partial pressure of end-tidal carbon dioxide (PETCO2 ) monitoring in children is important to detect apnea or hypopnea early to intervene before hypoxemia develops. Monitoring PETCO2 in children without a tracheal tube is challenging. To improve PETCO2 measurement accuracy in a commercially available mask with a mainstream CO2 detector, we implemented design changes with deform-and-hold shaping technology and anterior-posterior adjustment of the expiratory gas flow cup. METHODS: Two sizes of redesigned face masks (small for 7-20 kg, medium for 10-40 kg) were evaluated...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27941478/asynchrony-between-ventilator-flow-and-pressure-waveforms-and-the-capnograph-on-dr%C3%A3-ger-anesthesia-workstations
#11
Mukesh Tripathi, Nilay Tripathi, Mamta Pandey
Modern anesthesia workstations display capnography, flow-time, and pressure-time waveforms in real time. We observed that at certain ventilator settings (10 breaths/min) on Dräger workstations, the expiratory phase of the capnograph overlaps both the inspiratory and the expiratory phases of ventilation. This discrepancy disappears at respiratory rates of 16 breaths/min. This synchronous respiratory monitoring display at respiratory rates 16 breaths/min is not physiologically correct, because it implies a synchronization of waveforms that is not actually present...
December 9, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27939108/a-randomized-controlled-trial-of-end-tidal-carbon-dioxide-detection-of-preterm-infants-in-the-delivery-room
#12
Gavin A Hawkes, Daragh Finn, Mmoloki Kenosi, Vicki Livingstone, John M O'Toole, Geraldine B Boylan, Ken D O'Halloran, Anthony C Ryan, Eugene M Dempsey
OBJECTIVE: To compare the ability of qualitative versus quantitative methods of end-tidal carbon dioxide (EtCO2) detection to maintain normocarbia during face mask ventilation (FMV) of preterm infants (<32 weeks) in the delivery room. STUDY DESIGN: Preterm infants <32 weeks were randomly assigned to the use of a disposable PediCap EtCO2 detector (Covidien, Dublin, Ireland) (qualitative) or a Microstream side stream capnography device (Covidien) (quantitative) for FMV in the delivery room, via a NeoPuff T-piece resuscitator (Fisher and Paykel, Auckland, New Zealand)...
December 9, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27931628/the-role-of-equipment-in-endoscopic-complications
#13
REVIEW
Stepan Suchanek, Tomas Grega, Miroslav Zavoral
The role of the surrounding equipment in endoscopic complications has not been published widely. However, an adequate understanding of the advantages and disadvantages of such devices might be helpful to avoid unnecessary problems during endoscopy. This is an overview of the basic principles, benefits and possible harms of electrical power units, medical gases and vital sign monitoring equipment. The aim of this review is to summarize current knowledge about the approach to the electrosurgical unit settings; periprocedural precautions, minimizing the risk of interference between endoscopic equipment and other electrical devices; the appropriate selection of instruments regarding the electrosurgical outcome and the role of carbon dioxide, argon plasma coagulation, pulse oximetry and capnography...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27898550/severe-intraoperative-shock-related-to-mesenteric-traction-syndrome
#14
Alfredo Haack Couto, Hugo Siqueira, Pablo Pulcheira Brasileiro, Ismar Lima Cavalcanti, Rogério Luiz da Rocha Videira
Mesenteric traction syndrome is defined as arterial hypotension, facial flushing, and tachycardia related to mesenteric traction. We describe a case of mesenteric traction syndrome refractory to catecholamine and vasopressin infusions. The patient, who had Crohn disease, developed severe distributive shock after mesenteric traction while undergoing resection of an intestinal inflammatory mass, accompanied by facial flushing and unaltered readings for pulse oximetry, capnography, and bispectral index monitoring...
February 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/27766526/implementation-of-a-novel-postoperative-monitoring-system-using-automated-modified-early-warning-scores-mews-incorporating-end-tidal-capnography
#15
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27679799/prognostic-value-of-initial-assessment-of-residual-hypoventilation-using-nocturnal-capnography-in-mechanically-ventilated-neuromuscular-patients-a-5-year-follow-up-study
#16
Adam Ogna, Julie Nardi, Helene Prigent, Maria-Antonia Quera Salva, Cendrine Chaffaut, Laure Lamothe, Sylvie Chevret, Djillali Annane, David Orlikowski, Frederic Lofaso
BACKGROUND: Restrictive respiratory failure is a major cause of morbidity and mortality in neuromuscular diseases (NMD). Home mechanical ventilation (HMV) is used to treat hypoventilation, and its efficiency is mostly assessed by daytime blood gases or nocturnal oxygen saturation monitoring (SpO2). Non-invasive transcutaneous measure of CO2 (TcCO2) allows to directly assess nocturnal hypercapnia and to detect residual hypoventilation with a higher sensitivity than SpO2. We aimed to compare the prognostic value of nocturnal SpO2 and TcCO2 in ventilated adult NMD patients...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27671621/clinical-value-of-the-integrated-pulmonary-index-%C3%A2-during-sedation-for-interventional-upper-gi-endoscopy-a-randomized-prospective-tri-center-study
#17
Andrea Riphaus, Till Wehrmann, Tim Kronshage, Christoph Geist, Christian P Pox, Stefan Heringlake, Wolff Schmiegel, Analena Beitz, Alexander Meining, Michaela Müller, Stefan von Delius
BACKGROUND AND STUDY AIMS: The Integrated Pulmonary Index(®) (IPI) is a mathematically-determined factor based on parameters of capnography and pulse oximetry, which should enable sensitive detection of impaired respiratory function. Aim was to investigate whether an additional measurement of the IPI during sedation for interventional endoscopy, compared to standard monitoring alone, allows a reduction of sedation-related respiratory depression. PATIENTS AND METHODS: 170 patients with standard monitoring randomly underwent either a blinded recording of capnography (control group, n=87) or capnography, including automated IPI calculation (IPI group, n=83), during deep sedation with midazolam and propofol...
January 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27670357/feasibility-of-the-capnogram-to-monitor-ventilation-rate-during-cardiopulmonary-resuscitation
#18
Elisabete Aramendi, Andoni Elola, Erik Alonso, Unai Irusta, Mohamud Daya, James K Russell, Pia Hubner, Fritz Sterz
AIM: The rates of chest compressions (CCs) and ventilations are both important metrics to monitor the quality of cardiopulmonary resuscitation (CPR). Capnography permits monitoring ventilation, but the CCs provided during CPR corrupt the capnogram and compromise the accuracy of automatic ventilation detectors. The aim of this study was to evaluate the feasibility of an automatic algorithm based on the capnogram to detect ventilations and provide feedback on ventilation rate during CPR, specifically addressing intervals where CCs are delivered...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27667345/implementing-capnography-in-the-pacu%C3%A2-and-beyond
#19
Lois Oswald, Terry Zeuske, Joyanne Pfeffer
The potential risk of adverse effects from hypoventilation due to intravenous and/or intrathecal narcotic administration was recognized. Sauk Prairie Memorial Hospital and Clinics understood the limitations with the use of pulse oximetry and respiratory assessment in detecting adequate ventilation. Evidence has shown that capnography is the best indicator of respiratory depression. This article describes the implementation of monitoring program for high risk patients. Early recognition of respiratory depression via capnography has enabled Sauk Prairie Memorial Hospital to safely care for patients having intravenous and intrathecal narcotics...
October 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27663694/mainstream-capnography-system-for-nonintubated-children-in-the-postanesthesia-care-unit-performance-with-changing-flow-rates-and-a-comparison-to-side-stream-capnography
#20
Makoto Nagoshi, Rica Morzov, Justin Hotz, Paula Belson, Marla Matar, Patrick Ross, Randall Wetzel
INTRODUCTION: Monitoring of exhaled carbon dioxide (CO2 ) in nonintubated patients is challenging. We compared the precision of a mainstream mask capnography to side stream sampling nasal cannula capnography. In addition, we compared the effect of gas flow rates on the measured exhaled CO2 between mainstream mask and side stream nasal cannula capnography. METHODS: A mainstream mask capnography system (cap-ONE) was tested. Children (weight of 7-40 kg, ASA 1-2) following anesthesia for minor procedures were assigned randomly to side stream or mainstream sampling groups...
December 2016: Paediatric Anaesthesia
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