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Ali Taghizadieh, Mahboub Pouraghaei, Payman Moharamzadeh, Alireza Ala, Farzad Rahmani, Karim Basiri Sofiani
Introduction: The routine and gold standard method to diagnose of acid - base disturbance is arterial blood gas (ABG) sampling. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis. Methods: In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated...
2016: Journal of Cardiovascular and Thoracic Research
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
C Wallmüller, P Stratil, A Schober
The development of technical assist devices in the context of cardiopulmonary resuscitation (CPR) reaches back to the early roots of modern resuscitation research. This article covers the subjects of extracorporeal CPR (ECPR), including extracorporeal life support (ECLS), emergency ECLS (EECLS) and mechanical resuscitation devices. Specifically, the potential use of active compression-decompression CPR (ACD-CPR), impedance threshold devices (ITD) and capnography as additional measures during resuscitation are described in detail...
October 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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
Pradeep H Lakshminarayana, Adiba A Geeti, Umer M Darr, David A Kaufman
Dead space fraction (V d/V t) measurement performed using volumetric capnography requires arterial blood gas (ABG) sampling to estimate the partial pressure of carbon dioxide (PaCO2). In recent years, transcutaneous capnography (PtcCO2) has emerged as a noninvasive method of estimating PaCO2. We hypothesized that PtcCO2 can be used as a substitute for PaCO2 in the calculation of V d/V t. In this prospective pilot comparison study, 30 consecutive postcardiac surgery mechanically ventilated patients had V d/V t calculated separately using volumetric capnography by substituting PtcCO2 for PaCO2...
2016: Critical Care Research and Practice
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
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...
September 1, 2016: Digestive and Liver Disease
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...
September 23, 2016: Resuscitation
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
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...
September 24, 2016: Paediatric Anaesthesia
Cliff Reid, Ian Ferguson, Brian Burns, Karel Habig, Mohammed Shareef
BACKGROUND: Life-like end-tidal capnography (ETCO2) waveforms have been demonstrated in recently deceased and fresh-frozen cadavers following tracheal intubation, offering potential for high fidelity airway simulation training. As the mechanism for carbon dioxide production is not fully understood, it is possible that oesophageal intubation may also generate a capnograph. Our aim was to measure ETCO2 levels following (1) oesophageal and (2) tracheal intubation in fresh-frozen cadavers, and to observe the size, shape and duration of any capnographic waveform...
September 23, 2016: Emergency Medicine Journal: EMJ
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
Ali Jalali, Mohamed Rehman, Arul Lingappan, C Nataraj
This paper is concerned with the mathematical modeling and detection of endotracheal (ET) intubation in children under general anesthesia during surgery. In major pediatric surgeries, the airway is often secured with an endotracheal tube (ETT) followed by initiation of mechanical ventilation. Clinicians utilize auscultation of breath sounds and capnography to verify correct ETT placement. However, anesthesia providers often delay timely charting of ET intubation. This latency in event documentation results in decreased efficacy of clinical decision support systems...
November 2016: Journal of Dynamic Systems, Measurement, and Control
Matilde Zaballos, María Dolores Ginel, Maite Portas, María Barrio, Ana María López
BACKGROUND AND OBJECTIVES: The decision whether to manage an ambulatory patient with a previously documented difficult airway with a supraglottic device remain controversial. We report an awake insertion of a Laryngeal Mask Airway Proseal™ in a patient with known difficult airway scheduled for ambulatory surgery. CASE REPORT: A 46-yr-old woman was programmed as a day case surgery for breast nodule resection. Her anesthetic record included an impossible intubation with cancelation of surgery and subsequent awake fibroscopic intubation...
September 2016: Brazilian Journal of Anesthesiology
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
Charlotte Dewdney, Margaret MacDougall, Rachel Blackburn, Gavin Lloyd, Alasdair Gray
INTRODUCTION: Procedural sedation and analgesia (PSA) is commonplace in the ED. Previous studies have identified capnography as a reliable indicator of PSA-induced respiratory depression. This review investigates the potential effect on patient safety of the use of capnography in addition to standard monitoring for adult patients undergoing PSA in the ED. METHODS: MEDLINE, Embase, Scopus, CINAHL and Google Scholar were searched systematically for ED studies using capnography during PSA...
August 26, 2016: Emergency Medicine Journal: EMJ
Yutaka Sakaguchi, Eriko Aiba
Although there is growing evidence that breathing is modulated by various motor and cognitive activities, the nature of breathing in musical performance has been little explored. The present study examined the temporal breath pattern in piano performance, aiming to elucidate how breath timing is related to musical organization/events and performance. In the experiments, the respiration of 15 professional and amateur pianists, playing 10 music excerpts in total (from four-octave C major scale, Hanon's exercise, J...
2016: Frontiers in Human Neuroscience
Aaron Conway, Clint Douglas, Joanna R Sutherland
No abstract text is available yet for this article.
August 2016: American Journal of Gastroenterology
Adam Bullock, James M Dodington, Aaron J Donoghue, Melissa L Langhan
OBJECTIVE: Capnography is indicated as a guide to assess and monitor both endotracheal intubation and cardiopulmonary resuscitation (CPR). Our primary objective was to determine the effect of the 2010 American Heart Association (AHA) guidelines on the frequency of capnography use during critical events in children in the emergency department (ED). Our secondary objective was to examine associations between patient characteristics and capnography use among these patients. METHODS: A retrospective chart review was performed on children aged 0 to 21 years who were intubated or received CPR in 2 academic children's hospital EDs between January 2009 and December 2012...
July 23, 2016: Pediatric Emergency Care
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