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end tidal expired co2

Yi Liu, Jing-Sheng Lou, Wei-Dong Mi, Wei-Xiu Yuan, Qiang Fu, Min Wang, Jing Qu
BACKGROUND: The settings of mechanical ventilation, like tidal volume (VT), occasionally need to be adjusted in the process of anesthesia for some special reasons. The aim of this study was therefore to assess the relationship between pulse pressure variations (PPVs) in different settings of VT in anesthetized healthy patients under mechanical ventilation. METHODS: Sixty nine ASA I-II patients scheduled for gastrointestinal surgery under general anesthesia were included in this prospective study...
2016: BMC Anesthesiology
L W Sturesson, G Malmkvist, S Allvin, M Collryd, M Bodelsson, B Jonson
BACKGROUND: In acute lung injury, CO2 exchange is enhanced by prolonging the volume-weighted mean time for fresh gas to mix with resident alveolar gas, denoted mean distribution time (MDT), and by increasing the flow rate immediately before inspiratory flow interruption, end-inspiratory flow (EIF). The objective was to study these effects in human subjects without lung disease and to analyse the results with respect to lung-protective ventilation of healthy lungs. METHODS: During preparation for intracranial surgery, the lungs of eight subjects were ventilated with a computer-controlled ventilator, allowing breath-by-breath modification of the inspiratory flow pattern...
August 2016: British Journal of Anaesthesia
S E Rees, S Larraza, N Dey, S Spadaro, J B Brohus, R W Winding, C A Volta, D S Karbing
Incomplete expiration of tidal volume can lead to dynamic hyperinflation and auto-PEEP. Methods are available for assessing these, but are not appropriate for patients with respiratory muscle activity, as occurs in pressure support. Information may exist in expiratory flow and carbon dioxide measurements, which, when taken together, may help characterize dynamic hyperinflation. This paper postulates such patterns and investigates whether these can be seen systematically in data. Two variables are proposed summarizing the number of incomplete expirations quantified as a lack of return to zero flow in expiration (IncExp), and the end tidal CO2 variability (varETCO2), over 20 breaths...
June 25, 2016: Journal of Clinical Monitoring and Computing
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
Xiaojing Zhang, Pawel Wargocki, Zhiwei Lian
Twenty-five subjects were exposed to different levels of carbon dioxide (CO2 ) and bioeffluents. The ventilation rate was set high enough to create a reference condition of 500 ppm CO2 with subjects present; additional CO2 was then added to supply air to reach levels of 1,000 or 3,000 ppm, or the ventilation rate was reduced to allow metabolically-generated CO2 to reach the same two levels (bioeffluents increased as well). Heart rate, blood pressure, End-Tidal CO2 (ETCO2 ), oxygen saturation of blood (SPO2 ), respiration rate, nasal peak flow and forced expiration were monitored and the levels of salivary α-amylase and cortisol were analyzed...
February 10, 2016: Indoor Air
Randy F Crossland, Alex Mitchell, Antoni R Macko, James K Aden, James E Campbell, Forest R Sheppard
BACKGROUND: Heart rate (HR), systolic blood pressure (SBP) and mean arterial pressure (MAP) are traditionally used to guide patient triage and resuscitation; however, they correlate poorly to shock severity. Therefore, improved acute diagnostic capabilities are needed. Here, we correlated acute alterations in tissue oxygen saturation (StO2) and end-tidal carbon dioxide (ETCO2) to mortality in a rhesus macaque model of uncontrolled hemorrhage. METHODS: Uncontrolled hemorrhage was induced in anesthetized rhesus macaques by a laparoscopic 60% left-lobe hepatectomy (T = 0 minute)...
April 2016: Journal of Trauma and Acute Care Surgery
Elliott Shang-shun Li, Po-Yin Cheung, Megan O'Reilly, Joseph LaBossiere, Tze-Fun Lee, Shaun Cowan, David L Bigam, Georg Marcus Schmölzer
BACKGROUND: End-tidal CO2 (ETCO2), partial pressure of exhaled CO2 (PECO2), and volume of expired CO2 (VCO2) can be continuously monitored non-invasively to reflect pulmonary ventilation and perfusion status. Although ETCO2 ≥14 mmHg has been shown to be associated with return of an adequate heart rate in neonatal resuscitation and quantifying the PECO2 has the potential to serve as an indicator of resuscitation quality, there is little information regarding capnometric measurement of PECO2 and ETCO2 in detecting return of spontaneous circulation (ROSC) and survivability in asphyxiated neonates receiving cardiopulmonary resuscitation (CPR)...
2016: PloS One
Clara Conde Ruiz, Inga-Catalina Cruz Benedetti, Isabelle Guillebert, Karine Genevieve Portier
This prospective blinded randomized study aimed to determine whether the timing of morphine and phenylbutazone administration affects the breathing response to skin incision, recovery quality, behavior, and cardiorespiratory variables in horses undergoing fetlock arthroscopy. Ten Standardbred horses were premedicated with acepromazine (0.04 mg kg(-1) IM) and romifidine (0.04 mg kg(-1) IV). Anesthesia was induced with diazepam (0.05 mg kg(-1)) and ketamine (2.2 mg kg(-1)) IV at T0. Horses in group PRE (n = 5) received morphine (0...
2015: Frontiers in Veterinary Science
Marie-Cécile Nierat, Anna L Hudson, Joël Chaskalovic, Thomas Similowski, Louis Laviolette
In awake humans, breathing depends on automatic brainstem pattern generators. It is also heavily influenced by cortical networks. For example, functional magnetic resonance imaging and electroencephalographic data show that the supplementary motor area becomes active when breathing is made difficult by inspiratory mechanical loads like resistances or threshold valves, which is associated with perceived respiratory discomfort. We hypothesized that manipulating the excitability of the supplementary motor area with repetitive transcranial magnetic stimulation would modify the breathing pattern response to an experimental inspiratory load and possibly respiratory discomfort...
2015: Frontiers in Physiology
Ling Liu, Daijiro Takahashi, Haibo Qui, Arthur S Slutsky, Christer Sinderby, Jennifer Beck
BACKGROUND: During conventional Neurally Adjusted Ventilatory Assist (NAVA), the electrical activity of the diaphragm (EAdi) is used for triggering and cycling-off inspiratory assist, with a fixed PEEP (so called "Triggered Neurally Adjusted Ventilatory Assist" or "tNAVA"). However, significant post-inspiratory activity of the diaphragm can occur, believed to play a role in maintaining end-expiratory lung volume. Adjusting pressure continuously, in proportion to both inspiratory and expiratory EAdi (Continuous NAVA, or cNAVA), would not only offer inspiratory assist for tidal breathing, but also may aid in delivering a "neurally adjusted PEEP", and more specific breath-by-breath unloading...
2015: BMC Anesthesiology
Odette O, Sarah M Churgin, Kurt K Sladky, Lesley J Smith
Inland bearded dragons (Pogona vitticeps, n=6) were anesthetized for 1 hr using isoflurane in either 100% oxygen or 21% oxygen (FI 21; medical-grade room air). Parameters of anesthetic depth were recorded throughout both induction and recovery by an observer blinded to the fraction of inspired oxygen (FiO2), including the loss and return of withdrawal and righting reflexes, muscle tone, ability to intubate or extubate, and return to spontaneous respiration. Physiologic data were recorded every 5 min throughout the anesthetic procedures, including heart rate, body temperature, end-tidal CO2, hemoglobin oxygen saturation (SpO2), and percent expired isoflurane...
September 2015: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Jeroen J van Vonderen, Gianluca Lista, Francesco Cavigioli, Stuart B Hooper, Arjan B te Pas
OBJECTIVE: To measure tidal volume, plethysmography changes and gas exchange during respiratory support at birth. DESIGN: The following parameters were measured: (1) expired tidal volumes (Vte (mL/kg)) using respiratory function monitoring, (2) changes in plethysmography (AU/kg) per breath using respiratory inductance plethysmography (bands placed around rib cage (RC) and abdomen (AB)) and (3) expired CO2 (ECO2) levels using a volumetric CO2 monitor. For respiratory support, a T-piece resuscitator and facemask were used with peak inspiratory pressure (PIP) 25 cm H2O and positive end expiratory pressure 5 cm H2O...
November 2015: Archives of Disease in Childhood. Fetal and Neonatal Edition
Kenichi Satoh, Mami Chikuda, Ayako Ohashi, Miho Kumagai, Akiyoshi Kuji, Shigeharu Joh
Measurement of end-tidal carbon dioxide (PETCO2) is useful because of its noninvasiveness, continuity, and response time when sudden changes in ventilation occur during inhalation sedation. We compared the accuracy of PETCO2 using a nasal mask and nasal cannula with the accuracy of transcutaneous carbon dioxide (TC-CO2) and determined which method is more useful during inhalation sedation in volunteers. We used a modified nasal mask (MNM) and modified nasal cannula (MNC) for measurement of PETCO2. The capnometer measured PETCO2 in the gas expired from the nasal cavity by means of two devices...
August 2016: Journal of Clinical Monitoring and Computing
Andreas Fahlman, Stephen H Loring, Gregg Levine, Julie Rocho-Levine, Trevor Austin, Micah Brodsky
We measured esophageal pressures, respiratory flow rates, and expired O2 and CO2 in six adult bottlenose dolphins (Tursiops truncatus) during voluntary breaths and maximal (chuff) respiratory efforts. The data were used to estimate the dynamic specific lung compliance (sCL), the O2 consumption rate (V̇O2 ) and CO2 production rates (V̇CO2 ) during rest. Our results indicate that bottlenose dolphins have the capacity to generate respiratory flow rates that exceed 130 l s(-1) and 30 l s(-1) during expiration and inspiration, respectively...
July 2015: Journal of Experimental Biology
Carolyn Deng, Neal W Pollock, Nicholas Gant, Jacqueline A Hannam, Adam Dooley, Peter Mesley, Simon J Mitchell
INTRODUCTION: Closed-circuit underwater rebreather apparatus (CCR) recycles expired gas through a carbon dioxide (CO₂) 'scrubber'. Prior to diving, users perform a five-minute 'prebreathe' during which they self-check for symptoms of hypercapnia that might indicate a failure in the scrubber. There is doubt that this strategy is valid. METHODS: Thirty divers were block-randomized to breathe for five minutes on a circuit in two of the following three conditions: normal scrubber, partly-failed scrubber, and absent scrubber...
March 2015: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Lise Piquilloud, David Thevoz, Philippe Jolliet, Jean-Pierre Revelly
BACKGROUND: In acute respiratory failure, arterial blood gas analysis (ABG) is used to diagnose hypercapnia. Once non-invasive ventilation (NIV) is initiated, ABG should at least be repeated within 1 h to assess PaCO2 response to treatment in order to help detect NIV failure. The main aim of this study was to assess whether measuring end-tidal CO2 (EtCO2) with a dedicated naso-buccal sensor during NIV could predict PaCO2 variation and/or PaCO2 absolute values. The additional aim was to assess whether active or passive prolonged expiratory maneuvers could improve the agreement between expiratory CO2 and PaCO2...
2015: Annals of Intensive Care
H Arikawa, T Terada, T Takahashi, K Kizaki, H Imai, S Era
One distinctive trait of kendo, the Japanese martial art of fencing, is the execution of sustained, high-effort vocalizations during actions. The purpose of this study was to determine the effect of these vocalizations on respiratory functions. First, the intensity of 3 kendo exercises was quantified by measuring oxygen uptake (V̇O2) and comparing it with V̇O2max measured during treadmill tests of 8 university kendo athletes. Respiratory variables of these 8 athletes were then analyzed using a portable breath gas analyzer during the most intensive kendo exercise, kakari-keiko, with and without vocalization...
June 2015: International Journal of Sports Medicine
Ivan Cundrle, Virend K Somers, Bruce D Johnson, Christopher G Scott, Lyle J Olson
BACKGROUND: Increased CO2 chemosensitivity and augmented exercise ventilation are characteristic of patients with heart failure (HF) with central sleep apnea (CSA). The aim of this study was to test the hypothesis that decreased end-tidal CO2 by cardiopulmonary exercise testing predicts CSA in patients with HF. METHODS: Consecutive ambulatory patients with New York Heart Association II to III HF were prospectively evaluated by CO2 chemosensitivity by rebreathe, cardiopulmonary exercise testing, and polysomnography (PSG)...
June 2015: Chest
Vadivelam Murthy, Walton D'Costa, Raajul Shah, Grenville F Fox, Morag E Campbell, Anthony D Milner, Anne Greenough
BACKGROUND: Prematurely born infants may be resuscitated in the labour suite via a face mask or an endotracheal tube. AIMS: To assess prematurely born infants' initial responses to resuscitation delivered via an endotracheal tube or a face mask, to determine if the first five inflations via an endotracheal tube produced expired tidal volumes greater than 4.4ml/kg (twice the anatomical dead space) and whether the outcome of initial resuscitation via an endotracheal tube or via a face mask differed according to the first active inflation (the infant's inspiratory effort coinciding with an inflation)...
March 2015: Early Human Development
Isamu Ozaki, Kiyoshi Kurata
OBJECTIVE: To investigate the effects of voluntary deep breathing on the excitability of the hand area in the primary motor cortex (M1). METHODS: We applied near-threshold transcranial magnetic stimulation (TMS) over M1 during the early phase of inspiration or expiration in both normal automatic and voluntary deep, but not "forced", breathing in eight healthy participants at rest. We monitored exhaled CO2 levels continuously, and recorded motor-evoked potentials (MEPs) simultaneously from the abductor pollicis brevis, first dorsal interosseous, abductor digiti minimi, flexor digitorum superficialis, and extensor incidis muscles...
November 2015: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
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