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Capnography

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https://www.readbyqxmd.com/read/28819181/capnography-monitoring-the-hypoventilation-during-the-induction-of-bronchoscopic-sedation-a-randomized-controlled-trial
#1
Ting-Yu Lin, Yueh-Fu Fang, Shih-Hao Huang, Tsai-Yu Wang, Chih-Hsi Kuo, Hau-Tieng Wu, Han-Pin Kuo, Yu-Lun Lo
We hypothesize that capnography could detect hypoventilation during induction of bronchoscopic sedation and starting bronchoscopy following hypoventilation, may decrease hypoxemia. Patients were randomized to: starting bronchoscopy when hypoventilation (hypopnea, two successive breaths of at least 50% reduction of the peak wave compared to baseline or apnea, no wave for 10 seconds) (Study group, n = 55), or when the Observer Assessment of Alertness and Sedation scale (OAAS) was less than 4 (Control group, n = 59)...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28807576/evaluation-of-three-tidal-volumes-10-12-and-15%C3%A2-ml%C3%A2-kg-1-in-dogs-for-controlled-mechanical-ventilation-assessed-by-volumetric-capnography-a-randomized-clinical-trial
#2
Seline Bumbacher, Johannes P Schramel, Martina Mosing
OBJECTIVE: To evaluate three routinely used tidal volumes (VT; 10, 12 and 15 mL kg(-1)) for controlled mechanical ventilation (CMV) in lung-healthy anaesthetized dogs by assessing alveolar ventilation (VTalv) and dead space (DS). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 36 client-owned dogs. METHODS: Dogs were randomly allocated to a VT of 10 (G10), 12 (G12) or 15 (G15) mL kg(-1). After induction CMV was started...
May 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28754357/what-is-the-utility-of-end-tidal-capnography-for-procedural-sedation-and-analgesia-in-the-emergency-department
#3
EDITORIAL
Michael Gottlieb, Melissa Rice
No abstract text is available yet for this article.
July 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28750882/unrecognized-failed-airway-management-using-a-supraglottic-airway-device
#4
Veer D Vithalani, Sabrina Vlk, Steven Q Davis, Neal J Richmond
BACKGROUND: 911 Emergency Medical Services (EMS) systems utilize supraglottic devices for either primary advanced airway management, or for airway rescue following failed attempts at direct laryngoscopy endotracheal intubation. There is, however, limited data on objective confirmation of supraglottic airway placement in the prehospital environment. Furthermore, the ability of EMS field providers to recognize a misplaced airway is unknown. METHODS: Retrospective review of patients who underwent airway management using the King LTS-D supraglottic airway in a large urban EMS system, between 3/1/15-9/30/2015...
July 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28731933/continuous-capnography-reduces-the-incidence-of-opioid-induced-respiratory-rescue-by-hospital-rapid-resuscitation-team
#5
Mindy Stites, Jennifer Surprise, Jennifer McNiel, David Northrop, Martin De Ruyter
OBJECTIVE: The aim of this study was to determine the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory depression (OIRD) in the setting of rapid response. METHODS: A retrospective analysis was conducted in an urban tertiary care facility on the incidence of OIRD in the setting of rapid response as defined by a positive response to naloxone from January 2012 to December 2015...
July 20, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28730315/comparison-of-nellcor%C3%A2-pm1000n-and-masimo-radical-7-%C3%A2-for-detecting-apnea-in-volunteers
#6
Chanatthee Kitsiripant, Tomoko Fukada, Hiroko Iwakiri, Yuri Tsuchiya, Makoto Ozaki, Minoru Nomura
PURPOSE: Although capnography is considered the gold standard for monitoring of ventilation, it may not work accurately in some situations. We compared the performance of two non-invasive continuous respiratory rate (RR) monitors that are alternatives for the detection of respiratory depression. METHODS: Fifty healthy volunteers ≥20 years old were enrolled in this study. After monitoring of the volunteers was started by the Masimo Radical-7(®) and Nellcor™ PM1000N, they breathed at the rate of 12 breaths/min for 3 min and then stopped breathing...
July 20, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#7
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28695980/arterial-to-end-tidal-carbon-dioxide-difference-in-children-undergoing-mechanical-ventilation-of-the-lungs-during-general-anaesthesia
#8
C Onodi, P K Bühler, J Thomas, A Schmitz, M Weiss
Capnography (ETCO2 ) is routinely used as a non-invasive estimate of arterial carbon dioxide (PaCO2 ) levels in order to modify ventilatory settings, whereby it is assumed that there is a positive gap between PaCO2 and ETCO2 of approximately 0.5 kPa. However, negative values (ETCO2 > PaCO2 ) can be observed. We retrospectively analysed arterial to end-tidal carbon dioxide differences in 799 children undergoing general anaesthesia with mechanical ventilation of the lungs in order to elucidate predictors for a negative gap...
July 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28691980/sudden-increase-in-etco2-during-upper-endoscopy-under-general-endotracheal-anesthesia-suggests-the-presence-of-tracheoesophageal-fistula-a-case-report
#9
Rosemarie E Garcia Getting, Cynthia L Harris
Acquired tracheoesophageal fistula is a rare and devastating complication of lung cancer. The diagnosis is typically confirmed on barium esophagram. We report a case of a patient with lung cancer status after palliative chemoradiotherapy and esophageal stenting for malignant stenosis who presented with signs and symptoms suggestive of tracheoesophageal fistula; however, no evidence of fistula was found on barium esophagram. During subsequent esophagogastroduodenoscopy, the presence of a fistula was verified by capnography, given extreme elevations in end-tidal CO2 concentrations during endoscopic CO2 insufflation...
August 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28667196/patient-safety-during-procedural-sedation-using-capnography-monitoring-a-systematic-review-and-meta-analysis
#10
Rhodri Saunders, Michel M R F Struys, Richard F Pollock, Michael Mestek, Jenifer R Lightdale
OBJECTIVE: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone. DESIGN AND SETTING: Systematic literature review and random effects meta-analysis of randomised controlled trials (RCTs) reporting sedation-related adverse event incidence when adding capnography to visual assessment and pulse oximetry in patients undergoing PSA during ambulatory surgery in the hospital setting...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28663642/capnographic-analysis-of-minimum-mandatory-flow-rate-for-hudson-face-mask-a-randomized-double-blind-study
#11
Pranjali Kurhekar, T Krishna Prasad, Buddhan Rajarathinam, M S Raghuraman
BACKGROUND: Oxygen supplementation through Hudson type face mask is frequently used in perioperative settings. Hudson mask is a variable rate performance device with the risk of rebreathing. Studies using capnography to find out an actual fraction of rebreathing in spontaneously breathing patients are not available. AIMS: In this study, we analyzed the effects of different flow rates through Hudson mask with capnography on fractional inspired carbon dioxide (FiCO2)...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28662195/the-relationship-between-minute-ventilation-and-end-tidal-co2-in-intubated-and-spontaneously-breathing-patients-undergoing-procedural-sedation
#12
Jaideep H Mehta, George W Williams, Brian C Harvey, Navneet K Grewal, Edward E George
BACKGROUND: Monitoring respiratory status using end tidal CO2 (EtCO2), which reliably reflects arterial PaCO2 in intubated patients under general anesthesia, has often proven both inaccurate and inadequate when monitoring non-intubated and spontaneously breathing patients. This is particularly important in patients undergoing procedural sedation (e.g., endoscopy, colonoscopy). This can be undertaken in the operating theater, but is also often delivered outside the operating room by non-anesthesia providers...
2017: PloS One
https://www.readbyqxmd.com/read/28655954/end-tidal-capnography-and-upper-airway-ultrasonography-in-the-rapid-confirmation-of-endotracheal-tube-placement-in-patients-requiring-intubation-for-general-anaesthesia
#13
Chintamani Abhishek, Kartik Munta, S Manimala Rao, C N Chandrasekhar
BACKGROUND AND AIMS: Confirmation of correct endotracheal tube placement is essential immediately after intubation for general anaesthesia. In this study, we have compared upper airway ultrasonography (USG) with reference to capnography for rapid confirmation of endotracheal tube placement after general anaesthesia. METHODS: A prospective, single centre, observational study was conducted on 100 patients requiring tracheal intubation for general anaesthesia. Both capnography and upper airway USG were performed immediately after intubation to confirm the endotracheal tube (ETT) placement...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28611227/lung-injury-etiology-and-other-factors-influencing-the-relationship-between-dead-space-fraction-and-mortality-in-ards
#14
Richard H Kallet, Hanjing Zhuo, Kelly Ho, Michael S Lipnick, Antonio Gomez, Michael A Matthay
BACKGROUND: In ARDS, elevated pulmonary dead-space fraction (VD/VT) is a particularly strong indicator of mortality risk. Whether the magnitude of VD/VT is modified by the underlying etiology of ARDS and whether this influences the strength of its association with mortality remains unknown. We sought to elucidate the impact of ARDS etiology on VD/VT and also to determine whether ARDS severity, as classified by the Berlin definition, has correspondence with changes in VD/VT. METHODS: This single-center, retrospective, observational study (2010-2016) measured VD/VT in 685 subjects with ARDS as part of clinical management with lung-protective ventilation...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28591467/the-effect-of-impella-cp-on-cardiopulmonary-physiology-during-venoarterial-extracorporeal-membrane-oxygenation-support
#15
Hoong Sern Lim
Left ventricle (LV) distension is a complication of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. The effects of Impella on the pulmonary circulatory physiology were studied in a single-center study of six consecutive patients on VA-ECMO support who had LV unloading with Impella. Right ventricular stroke volume, pulmonary hemodynamics, and partial pressure of end-tidal CO2 (PETCO2 ) were measured on echocardiogram, pulmonary artery catheter, and capnography, respectively. The addition of Impella CP increased total blood flow and reduced pulmonary artery wedge pressure...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28584436/titration-of-ideal-positive-end-expiratory-pressure-in-acute-respiratory-distress-syndrome-comparison-between-lower-inflection-point-and-esophageal-pressure-method-using-volumetric-capnography
#16
Nandakishore Baikunje, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Ritesh Agarwal
The tenets of mechanical ventilation in acute respiratory distress syndrome (ARDS) include the utilization of low tidal volume and optimal application of positive end-expiratory pressure (PEEP). Optimal PEEP in ARDS is characterized by reduction in alveolar dead space along with improvement in the lung compliance and resultant betterment in oxygenation. There are various methods of setting PEEP in ARDS. Herein, we report a patient of ARDS, wherein we employed measurement of dead space using volumetric capnography to compare two different PEEP strategies, namely, the lower inflection point and transpulmonary pressure monitoring...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28584427/reliability-of-ultrasonography-in-confirming-endotracheal-tube-placement-in-an-emergency-setting
#17
Vimal Koshy Thomas, Cherish Paul, Punchalil Chathappan Rajeev, Babu Urumese Palatty
BACKGROUND AND OBJECTIVES: Over the past few years, ultrasonography is increasingly being used to confirm the correct placement of endotracheal tube (ETT). In our study, we aimed to compare it with the traditional clinical methods and the gold standard quantitative waveform capnography. Two primary outcomes were measured in our study. First was the sensitivity and specificity of ultrasonography against the other two methods to confirm endotracheal intubation. The second primary outcome assessed was the time taken for each method to confirm tube placement in an emergency setting...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28574856/camera-based-measurement-of-respiratory-rates-is-reliable
#18
Christoph Becker, Stefan Achermann, Mukul Rocque, Ihor Kirenko, Andreas Schlack, Thomas Dreher-Hummel, Thomas Zumbrunn, Roland Bingisser, Christian H Nickel
OBJECTIVES: Respiratory rate (RR) is one of the most important vital signs used to detect whether a patient is in critical condition. It is part of many risk scores and its measurement is essential for triage of patients in emergency departments. It is often not recorded as measurement is cumbersome and time-consuming. We intended to evaluate the accuracy of camera-based measurements as an alternative measurement to the current practice of manual counting. MATERIALS AND METHODS: We monitored the RR of healthy male volunteers with a camera-based prototype application and simultaneously by manual counting and by capnography, which was considered the gold standard...
June 1, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28570147/estimating-arterial-partial-pressure-of-carbon-dioxide-in-ventilated-patients-how-valid-are-surrogate-measures
#19
Boulos S Nassar, Gregory A Schmidt
The arterial partial pressure of carbon dioxide (PaCO2) is an important parameter in critically ill, mechanically ventilated patients. To limit invasive procedures or for more continuous monitoring of PaCO2, clinicians often rely on venous blood gases, capnography, or transcutaneous monitoring. Each of these has advantages and limitations. Central venous Pco2 allows accurate estimation of PaCO2, differing from it by an amount described by the Fick principle. As long as cardiac output is relatively normal, central venous Pco2 exceeds the arterial value by approximately 4 mm Hg...
June 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28562388/procedural-sedation-in-the-icu-and-emergency-department
#20
Nikhil Chawla, Adjoa Boateng, Ranjit Deshpande
PURPOSE OF REVIEW: Procedures are increasingly being performed in the acute care setting, outside of the operating rooms (OR). This article aims to review the current literature on out-of-OR procedural sedation with a focus on the ICU and emergency department, highlighting the following topics: multidisciplinary team approach, choice of pharmacologic agent, sedation scales, current safety guidelines, anticipating complications, appropriate monitoring and necessary resources. RECENT FINDINGS: Subjective assessment of sedation using sedation scales is controversial...
August 2017: Current Opinion in Anaesthesiology
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