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End tidal CO2

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
Seong-Hoon Seok, Dong-Hyuk Jeong, Il-Hwa Hong, Hee-Chun Lee, Seong-Chan Yeon
Anesthesia is an inevitably important component of diagnosis and treatments examining the health condition of wild animals. Not only does anesthesia become an essential tool in minimizing stress of the patients and providing an opportunity to deliver accurate and safe procedures, but it also ensures the safety of the medical crew members. This study was conducted to investigate the dose-response cardiorespiratory effects of isoflurane during spontaneous ventilation in ten cinereous vultures. Each bird was administered isoflurane at initial concentration of 1...
September 30, 2016: Journal of Veterinary Medical Science
Dong-Hyuk Jeong, Jeong-Jin Yang, Seong-Hoon Seok, Dong-Joo Song, Seong-Chan Yeon
The objective of this study was to determine the dose-dependent effects of isoflurane on various cardiovascular parameters and the stable range of isoflurane concentrations in Asiatic black bears (Ursus thibetanus). Seven Asiatic black bears were intramuscularly injected with medetomidine, zolazepam, and tiletamine (MZT) to induce anesthesia and anesthesia was maintained by administering isoflurane in 100% oxygen (4 l/min) without mechanical ventilation. Several cardiovascular parameters were measured at five end-tidal isoflurane concentrations (0...
September 30, 2016: Journal of Veterinary Medical Science
Melvin E Stone, Stanley Kalata, Anna Liveris, Zachary Adorno, Shira Yellin, Edward Chao, Srinivas H Reddy, Michael Jones, Carlos Vargas, Sheldon Teperman
BACKGROUND: Critical administration threshold (≥3 units of packed red blood cells/h or CAT+) has been proposed as a new definition for massive transfusion (MT) that includes volume and rate of blood transfusion. CAT+ has been shown to eliminate survivor bias and be a better predictor of mortality than the traditional MT (>10 units/24h). End-tidal CO2 (ET CO2) negatively correlates with lactate and is an early predictor of shock in trauma patients. We conducted a pilot study to test the hypothesis that low ET CO2 on admission predicts CAT+...
July 5, 2016: Injury
Maria Skytioti, Signe Søvik, Maja Elstad
Intact cerebral blood flow (CBF) is essential for cerebral metabolism and function, whereas hypoperfusion in relation to hypovolemia and hypocapnia can lead to severe cerebral damage. This study was designed to assess internal carotid artery blood flow (ICA-BF) during simulated hypovolemia and noninvasive positive pressure ventilation (PPV) in young healthy humans. Beat-by-beat blood velocity (ICA and aorta) were measured by Doppler ultrasound during normovolemia and simulated hypovolemia (lower body negative pressure), with or without PPV in 15 awake subjects...
October 2016: Physiological Reports
Alcides Rocha, Flavio F Arbex, Maria Clara N Alencar, Priscila A Sperandio, Daniel M Hirai, Danilo C Berton, Denis E O'Donnell, J Alberto Neder
BACKGROUND: Exercise oscillatory ventilation (EOV) is associated with poor ventilatory efficiency and higher operating lung volumes in heart failure. These abnormalities may be particularly deleterious to dyspnea and exercise tolerance in mechanically-limited patients, e.g. those with coexistent COPD. METHODS: Ventilatory, gas exchange and sensory responses to incremental exercise were contrasted in 68 heart failure-COPD patients (12 EOV+). EOV was established by standard criteria...
September 24, 2016: International Journal of Cardiology
T Wesley Templeton, Lauren K Hoke, Jill Yaung, Carol A Aschenbrenner, Danielle M Rose, Leah B Templeton, Yvon F Bryan
STUDY OBJECTIVE: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in pediatric patients with a ProSeal laryngeal mask airway (PLMA). DESIGN: Randomized prospective study. SETTING: Pediatric hospital of a tertiary care academic medical center. PATIENTS: Thirty-three, American Society of Anesthesiologists classification 1-2, pediatric patients (12 months to 5 years)...
November 2016: Journal of Clinical Anesthesia
Richard L Hughson, Nicholas J Yee, Danielle K Greaves
BACKGROUND: Elevated ambient Pco2 in the International Space Station (ISS) has been cited as a potential contributor to the vision impairment intracranial pressure syndrome (VIIP), a significant health risk for astronauts during long-duration space missions. The elevation in ambient Pco2 is rather modest and normal respiratory compensation could minimize the impact on arterial Pco2. METHODS: In nine male astronauts, breaths measured prior to a rebreathing maneuver were examined to assess inspired and end-tidal Pco2 during upright seated preflight and in-flight conditions...
2016: Aerospace Medicine and Human Performance
Xavier Waltz, Andrew E Beaudin, Patrick J Hanly, Georgios D Mitsis, Marc J Poulin
Cerebral autoregulation (CA) impairment may contribute to the increased risk of stroke associated with obstructive sleep apnea (OSA). It is unknown if impaired CA is further exacerbated by isocapnic-hypoxia and whether it is improved by treatment of OSA with continuous positive airway pressure (CPAP). CA was assessed during wakefulness in 53 OSA patients (50.3 ± 9.3 years) and 21 controls (49.8 ± 8.6 years) at baseline and following a minimum of 1 month of effective CPAP therapy (OSA patients, n = 40)...
September 20, 2016: Journal of Physiology
An-Yi Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Chih-Hung Wang, Wen-Jone Chen
INTRODUCTION: Monitoring the partial pressure of end-tidal carbon dioxide (PEtco2) has been advocated since 2010 as an index of resuscitation efforts. However, related research has largely focused on out-of-hospital cardiac arrest victims. In-hospital cardiac arrest (IHCA) differs in terms of etiologies and demographics, the merit of initial PEtco2 values was explored. METHODS: This was a retrospective study in a single medical center between February 2011 and August 2014...
August 27, 2016: American Journal of Emergency Medicine
Florent Baudin, Pierre Bourgoin, David Brossier, Sandrine Essouri, Guillaume Emeriaud, Marc Wysocki, Philippe Jouvet
OBJECTIVES: The aim of our pilot study was to develop a model to better predict Paco2 in mechanically ventilated children using noninvasive parameters including volumetric capnography. DESIGN: Prospective clinical pilot study. SETTING: Level III PICU. PATIENTS: Sixty-five mechanically ventilated children. INTERVENTIONS: None. MATERIALS AND METHODS: We conducted a prospective clinical pilot study that included all children admitted to the PICU (< 18 yr; weight, > 3 kg; mechanically ventilated, > 6 hr; with an arterial line)...
September 14, 2016: Pediatric Critical Care Medicine
Gidugu Himashree, Latika Mohan, Yogesh Singh
UNLABELLED: Context • High altitude (HA) is a psychophysiological stressor for natives of lower altitudes. Reducing the morbidity and optimizing the performance of individuals deployed in an HA region has been attempted and reported with varied results. Objective • The present study intended to explore the effects of comprehensive yogic practices on the health and performance of Indian soldiers deployed at HAs. Design • The research team designed a prospective, randomized, case-control study...
September 2016: Alternative Therapies in Health and Medicine
Sibei Chen, Ying Li, Zeguang Zheng, Qun Luo, Rongchang Chen
BACKGROUND: This study is to explore the components and related mechanism responsible for the increase of work of breathing (WB) in chronic obstructive pulmonary disease (COPD) patients. METHODS: Eight COPD patients and eight healthy volunteers were recruited in the study. The rebreathing method was used to increase end-tidal CO2 partial pressure (PetCO2) and stimulate the increase in ventilation (VE). The increase in VE, WB, and changes in the compositions of WB were observed and analyzed...
August 2016: Journal of Thoracic Disease
Yayoi Ohashi, Leyla Baghirzada, Hiroyuki Sumikura, Mrinalini Balki
Japan has seen significant developments in obstetric anesthesia in recent years, including the establishment of the Japanese Society of Obstetric Anesthesia and Perinatology. However, labor pain, which is one of the most important issues in obstetric practice, is still not treated aggressively. The rate of epidural administration for labor analgesia is very low in Japan as compared to other developed countries. Remifentanil has been used for labor analgesia, as part of general anesthesia for cesarean delivery, as well as for various fetal procedures around the world...
September 12, 2016: Journal of Anesthesia
Frank Rasulo, Nicola Zugni, Simone Piva, Nazzareno Fagoni, Federico Pe, Arturo Toninelli, Stefano Calza, Nicola Latronico
BACKGROUND: Supraglottic airway devices (SGDs) are of current use in anesthesia practice and in emergency conditions. It has been suggested that cerebral blood flow (CBF) can decrease after SGD insertion or cuff inflation; however, it is uncertain if this reduction is caused by the SGD or the anesthetic drugs utilized for the anesthetic procedure. During minor surgery we separated CBF measurements by an adequate time interval in order to measure the distinctive changes in cerebral hemodynamics associated with anesthesia induction, SGD insertion and cuff inflation...
August 2016: Minerva Anestesiologica
Christopher A Gerdung, Adetayo Adeleye, Valerie G Kirk
PURPOSE OF REVIEW: Sleep-related breathing disorders are complex conditions that require the integration of clinical and sleep laboratory findings to support a diagnosis. Analysis of carbon dioxide (CO2) levels during sleep provides important additional information to the clinician that is not obtained from other polysomnographic indices, and that may have a direct impact on both diagnosis and patient mortality. Although arterial blood gas (ABG) is considered the gold standard for assessing PaCO2 levels, there are numerous drawbacks...
November 2016: Current Opinion in Pulmonary Medicine
Wail N Khraise, Mohammed Z Allouh, Mohammad Y Hiasat, Raed S Said
BACKGROUND Intraoperative pulmonary embolism (PE) is a rare life-threatening complication in patients undergoing surgical intervention. Generally, cancer patients have a higher risk for developing this complication. Unfortunately, there is no standard procedure for its management. CASE REPORT We report the case of a 39-year-old woman with high-grade glioma in the right frontal lobe who was admitted to the surgical theater for craniotomy and excision of the tumor. During the general anesthesia procedure and just before inserting the central venous line, her end-tidal CO2 and O2 saturation dropped sharply...
2016: American Journal of Case Reports
Chia-Man Chou, Chou-Ming Yeh, Sheng-Yang Huang, Hou-Chuan Chen
BACKGROUND: The field of laparoscopic surgery in neonates or younger infants has benefitted from recent progress. This study aimed to determine the correlation between patient characteristics and perioperative parameters, and to explore the feasibility of laparoscopic surgery in neonates and infants. METHODS: We retrospectively collected and analyzed data on neonates and infants who received laparoscopic surgery at our institute between January 2007 and August 2015...
October 2016: Journal of the Chinese Medical Association: JCMA
Gerd Schmalisch
Although capnography is a standard tool in mechanically ventilated adult and pediatric patients, it has physiological and technical limitations in neonates. Gas exchange differs between small and adult lungs due to the greater impact of small airways on gas exchange, the higher impact of the apparatus dead space on measurements due to lower tidal volume and the occurrence of air leaks in intubated patients. The high respiratory rate and low tidal volume in newborns, especially those with stiff lungs, require main-stream sensors with fast response times and minimal dead-space or low suction flow when using side-stream measurements...
2016: Biomedical Engineering Online
Wenqing Lu, Jijian Zheng, Lingqi Gao, Yingtian Wang
STUDY OBJECTIVE: To compare the efficacy of lightwand-guided classic laryngeal mask airway (cLMA) real-time insertion technique with the standard recommended index finger-guided insertion technique. DESIGN: Prospective, randomized controlled study. SETTING: University-affiliated hospital. PATIENTS: Three hundred patients undergoing minor gynecological or orthopedic surgeries under general anesthesia using the cLMA as an airway management tool...
September 2016: Journal of Clinical Anesthesia
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