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capnography curve

Jatinder Singh Minhas, Ronney B Panerai, Thompson G Robinson
 Arterial CO<sub>2</sub> (PaCO<sub>2</sub>) has a strong effect on cerebral blood flow (CBF), but its influence on CBF regulatory mechanisms and circulatory systemic variables has not been fully described over the entire physiological range of PaCO<sub>2</sub>. 
 CBF velocity (CBV, transcranial Doppler), blood pressure (BP, Finometer) and end-tidal CO<sub>2</sub> (EtCO<sub>2</sub>, capnography) were measured in 45 healthy volunteers (19 male, mean age 37...
May 23, 2018: Physiological Measurement
Mads F Bertelsen, Carsten Grøndahl, George F Stegmann, Cathrine Sauer, Niels H Secher, J Michael Hasenkam, Mads Damkjær, Christian Aalkjær, Tobias Wang
This study evaluated the accuracy of pulse oximetry, capnography, and oscillometric blood pressure during general anesthesia in giraffes (Giraffa camelopardalis). Thirty-two giraffes anesthetized for physiologic experiments were instrumented with a pulse oximeter transmittance probe positioned on the tongue and a capnograph sampling line placed at the oral end of the endotracheal tube. A human size 10 blood pressure cuff was placed around the base of the tail, and an indwelling arterial catheter in the auricular artery continuously measured blood pressure...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
L Beishon, C A L Williams, R B Panerai, T G Robinson, V J Haunton
INTRODUCTION: Cerebral blood flow velocity (CBFv) changes occurring with cognitive stimulation can be measured by Transcranial Doppler ultrasonography (TCD). The aim of this study was to assess the reproducibility of CBFv changes to the Addenbrooke's cognitive examination (ACE-III). NEW METHOD: 13 volunteers underwent bilateral TCD (middle cerebral artery), continuous heart rate (HR, 3-lead ECG, Finometer), beat-to-beat mean arterial pressure (MAP, Finometer), and end-tidal CO2 (ETCO2, capnography)...
November 1, 2017: Journal of Neuroscience Methods
Nimesh D Naik, Matthew C Hernandez, Jeff R Anderson, Erika K Ross, Martin D Zielinski, Johnathon M Aho
BACKGROUND: The success of needle decompression for tension pneumothorax is variable, and there are no objective measures assessing effective decompression. Colorimetric capnography, which detects carbon dioxide present within the pleural space, may serve as a simple test to assess effective needle decompression. METHODS: Three swine underwent traumatically induced tension pneumothorax (standard of care, n = 15; standard of care with needle capnography, n = 15)...
November 2017: Chest
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...
December 2017: IEEE Transactions on Bio-medical Engineering
J R Caldas, R B Panerai, V J Haunton, J P Almeida, G S R Ferreira, L Camara, R C Nogueira, E Bor-Seng-Shu, M L Oliveira, R R V Groehs, L Ferreira-Santos, M J Teixeira, F R B G Galas, T G Robinson, F B Jatene, L A Hajjar
Patients with ischemic heart failure (iHF) have a high risk of neurological complications such as cognitive impairment and stroke. We hypothesized that iHF patients have a higher incidence of impaired dynamic cerebral autoregulation (dCA). Adult patients with iHF and healthy volunteers were included. Cerebral blood flow velocity (CBFV, transcranial Doppler, middle cerebral artery), end-tidal CO2 (capnography), and arterial blood pressure (Finometer) were continuously recorded supine for 5 min at rest. Autoregulation index (ARI) was estimated from the CBFV step response derived by transfer function analysis using standard template curves...
January 1, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Julian Arévalo-Ludeña, Jose Juan Arcas-Bellas, Rafael Alvarez-Rementería, Luis Enrique Muñoz Alameda
STUDY OBJECTIVE: To assess the viability of performing fiberoptic-guided orotracheal intubation through the i-gel airway device previously inserted in spontaneously breathing patients with predicted difficult airway to achieve a patent airway. DESIGN: Prospective observational study. SETTING: Operating room in a tertiary care hospital. PATIENTS: Eighty-five adult patients with at least 3 difficult airway predictors or difficult airway management history were included...
December 2016: Journal of Clinical Anesthesia
H E Landsdalen, M Berge, F Kristensen, A B Guttormsen, E Søfteland
INTRODUCTION: supraglottic airway devices remain, despite advances in video laryngoscopy, important tools in the management of unexpected difficult airways. Intubation through a functioning supraglottic airway device with the aid of a fiberoptic bronchoscope is a well-known technique usually performed in apnoea. With a simple modification, the patient can be ventilated during this procedure. METHODS: In this observational study, Tracheal intubation Assisted by Bronchoscopy And Sad during Continuous Oxygenation (TABASCO) was performed as part of department training routine in 26 elective, fasted patients...
January 2017: Acta Anaesthesiologica Scandinavica
Yu-Jiao Zhang, Xin-Jing Gao, Zhi-Bo Li, Zhi-Yong Wang, Quan-Sheng Feng, Cheng-Fen Yin, Xing Lu, Lei Xu
PURPOSE: This prospective observational study aims to evaluate the accuracy of dead-space fraction derived from the ventilator volumetric capnography (volumetric CO₂) or a prediction equation to predict the survival of mechanically ventilated patients with acute respiratory distress syndrome (ARDS). METHODS: Consecutive VD/VT measurements were obtained based upon a prediction equation validated by Frankenfield et al for dead-space ventilation fraction: VD/VT = 0...
June 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Silvia Maria Doria da Silva, Ilma Aparecida Paschoal, Eduardo Mello De Capitani, Marcos Mello Moreira, Luciana Campanatti Palhares, Mônica Corso Pereira
BACKGROUND: Computed tomography (CT) phenotypic characterization helps in understanding the clinical diversity of chronic obstructive pulmonary disease (COPD) patients, but its clinical relevance and its relationship with functional features are not clarified. Volumetric capnography (VC) uses the principle of gas washout and analyzes the pattern of CO2 elimination as a function of expired volume. The main variables analyzed were end-tidal concentration of carbon dioxide (ETCO2), Slope of phase 2 (Slp2), and Slope of phase 3 (Slp3) of capnogram, the curve which represents the total amount of CO2 eliminated by the lungs during each breath...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Ralphe Bou Chebl, Bryan Madden, Justin Belsky, Elie Harmouche, Lenar Yessayan
BACKGROUND: Diabetic Ketoacidosis (DKA) is a potentially life-threatening emergency that requires prompt diagnosis and treatment. In paediatric populations an end tidal capnography value greater than 36 mmHg was found to be 100 % sensitive in ruling out DKA. METHODS: A cross sectional observational study of adults ≥ 17 years of age presenting to the emergency department between January 2014 and May 2014 with glucose > 550 mg/dL. In all patients, nasal capnography and venous blood gas analysis were performed prior to any insulin or intravenous fluid administration...
January 29, 2016: BMC Emergency Medicine
George Georgoulis, Eirini Papagrigoriou, Marc Sindou
BACKGROUND: A crucial aspect of surgery on the supraclavicular region, lateral neck, and mid-cervical vertebral region is the identification and sparing of the phrenic nerve and cervical (C4) root that are responsible for diaphragmatic innervation. Therefore intraoperative mapping of these nerve structures can be useful for difficult cases. Electrical stimulation with simultaneous observation of the ventilator waveforms of the anesthesia machine provides an effective method for the precise intraoperative mapping of these structures...
December 2015: Acta Neurochirurgica
Eric H Chou, Eitan Dickman, Po-Yang Tsou, Mark Tessaro, Yang-Ming Tsai, Matthew Huei-Ming Ma, Chien-Chang Lee, John Marshall
OBJECTIVE: This study aimed to undertake a systematic review and meta-analysis to summarize evidence on the diagnostic value of ultrasonography for the assessment of endotracheal tube placement in adult patients. METHODS: The major databases, PubMed, EMBASE, and the Cochrane Library, were searched for studies published from inception to June 2014. We selected studies that used ultrasonography to confirm endotracheal tube placement. The search was limited to human studies, and had no publication date or country restrictions...
May 2015: Resuscitation
Angela S M Salinet, Thompson G Robinson, Ronney B Panerai
Cerebral blood flow (CBF) regulation can be impaired in acute ischemic stroke but the combined effects of dynamic cerebral autoregulation (CA), CO2 cerebrovascular reactivity (CVR), and neurovascular coupling (NVC), obtained from simultaneous measurements, have not been described. CBF velocity in the middle cerebral artery (MCA) (CBFv, transcranial Doppler), blood pressure (BP, Finometer), and end-tidal Pco2 (PetCO2 , infrared capnography) were recorded during a 1-min passive movement of the arm in 27 healthy controls [mean age (SD) 61...
January 15, 2015: Journal of Applied Physiology
C L Herry, D Townsend, G C Green, A Bravi, A J E Seely
Variability analysis of respiratory waveforms has been shown to provide key insights into respiratory physiology and has been used successfully to predict clinical outcomes. The current standard for quality assessment of the capnogram signal relies on a visual analysis performed by an expert in order to identify waveform artifacts. Automated processing of capnograms is desirable in order to extract clinically useful features over extended periods of time in a patient monitoring environment. However, the proper interpretation of capnogram derived features depends upon the quality of the underlying waveform...
December 2014: Physiological Measurement
Liliani Veronez, Monica Corso Pereira, Silvia Maria Doria da Silva, Luisa Affi Barcaui, Eduardo Mello De Capitani, Marcos Mello Moreira, Ilma Aparecida Paschoal
BACKGROUND: Obstructive lung diseases of different etiologies present with progressive peripheral airway involvement. The peripheral airways, known as the silent lung zone, are not adequately evaluated with conventional function tests. The principle of gas washout has been used to detect pulmonary ventilation inhomogeneity and to estimate the location of the underlying disease process. Volumetric capnography (VC) analyzes the pattern of CO2 elimination as a function of expired volume...
2014: International Journal of Chronic Obstructive Pulmonary Disease
Hung-Te Hsu, Shah-Hwa Chou, Chun-Yen Chou, Kuang-Yi Tseng, Yi-Wei Kuo, Mei-Chun Chen, Kuang-I Cheng
BACKGROUND: The use of a video-assisted laryngoscope (VL) has been shown to reduce the time to achieve intubation with a double-lumen endobronchial tube (DLT). As the blade of the VL is curved differently to a standard laryngoscope, the DLT must be angled into a hockey stick shape to fit properly. We conducted a study to establish which direction of angulation was best to facilitate correct positioning of the DLT when using a VL. METHODS: We enrolled patients scheduled for thoracic surgery who required intubation with a DLT...
2014: BMC Anesthesiology
Guang-Sheng Qi, Wen-Chao Gu, Wen-Lan Yang, Feng Xi, Hao Wu, Jin-Ming Liu
PURPOSE: The aim of our study was to evaluate volumetric capnography (VCap) in the differentiation between chronic obstructive pulmonary disease (COPD) patients and normal subjects. PATIENTS AND METHODS: Thirty-nine healthy male volunteers and 60 male COPD patients were enrolled. Regression equations between VCap indices and age, weight, height, and tidal volume in healthy volunteers were established by stepwise regression analysis. Predicted normal values of VCap indices in COPD patients were calculated...
October 2014: Lung
Rebecca J Mieloszyk, George C Verghese, Kenneth Deitch, Brendan Cooney, Abdullah Khalid, Milciades A Mirre-Gonzalez, Thomas Heldt, Baruch S Krauss
We develop an approach to quantitative analysis of carbon dioxide concentration in exhaled breath, recorded as a function of time by capnography. The generated waveform--or capnogram--is currently used in clinical practice to establish the presence of respiration as well as determine respiratory rate and end-tidal CO 2 concentration. The capnogram shape also has diagnostic value, but is presently assessed qualitatively, by visual inspection. Prior approaches to quantitatively characterizing the capnogram shape have explored the correlation of various geometric parameters with pulmonary function tests...
December 2014: IEEE Transactions on Bio-medical Engineering
Andrew J E Seely, Andrea Bravi, Christophe Herry, Geoffrey Green, André Longtin, Tim Ramsay, Dean Fergusson, Lauralyn McIntyre, Dalibor Kubelik, Donna E Maziak, Niall Ferguson, Samuel M Brown, Sangeeta Mehta, Claudio Martin, Gordon Rubenfeld, Frank J Jacono, Gari Clifford, Anna Fazekas, John Marshall
INTRODUCTION: Prolonged ventilation and failed extubation are associated with increased harm and cost. The added value of heart and respiratory rate variability (HRV and RRV) during spontaneous breathing trials (SBTs) to predict extubation failure remains unknown. METHODS: We enrolled 721 patients in a multicenter (12 sites), prospective, observational study, evaluating clinical estimates of risk of extubation failure, physiologic measures recorded during SBTs, HRV and RRV recorded before and during the last SBT prior to extubation, and extubation outcomes...
April 8, 2014: Critical Care: the Official Journal of the Critical Care Forum
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