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volumetric capnography

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https://www.readbyqxmd.com/read/27856714/nasal-high-flow-reduces-dead-space
#1
Winfried Möller, Sheng Feng, Ulrike Domanski, Karl-Josef Franke, Gülnaz Celik, Peter Bartenstein, Sven Becker, Gabriele Meyer, Otmar Schmid, Oliver Eickelberg, Stanislav Tatkov, Georg Nilius
Recent studies show that nasal high flow (NHF) therapy can support ventilation in patients with acute or chronic respiratory disorders. Clearance of dead-space has been suggested as being the key mechanisms of respiratory support with NHF therapy. The hypothesis of this study was that NHF in a dose-dependent manner can clear dead space of the upper airways from expired air and decrease re-breathing. The randomized cross-over study involved 10 volunteers using scintigraphy with (81m)Krypton-gas ((81m)Kr-gas) during a breath-holding maneuver with closed mouth and in three nasally breathing tracheotomized patients by volumetric capnography and oximetry through sampling CO2 and O2 in the trachea and measuring the inspired volume with inductance plethysmography following NHF rates of 15, 30 and 45 L/min...
November 17, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27688911/can-transcutaneous-co2-tension-be-used-to-calculate-ventilatory-dead-space-a-pilot-study
#2
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
https://www.readbyqxmd.com/read/27632057/noninvasive-estimation-of-arterial-co2-from-end-tidal-co2-in-mechanically-ventilated-children-the-graedient-pilot-study
#3
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
https://www.readbyqxmd.com/read/27576441/current-methodological-and-technical-limitations-of-time-and-volumetric-capnography-in-newborns
#4
REVIEW
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...
August 30, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/27334879/volumetric-capnography-lessons-from-the-past-and-current-clinical-applications
#5
REVIEW
Sara Verscheure, Paul B Massion, Franck Verschuren, Pierre Damas, Sheldon Magder
Dead space is an important component of ventilation-perfusion abnormalities. Measurement of dead space has diagnostic, prognostic and therapeutic applications. In the intensive care unit (ICU) dead space measurement can be used to guide therapy for patients with acute respiratory distress syndrome (ARDS); in the emergency department it can guide thrombolytic therapy for pulmonary embolism; in peri-operative patients it can indicate the success of recruitment maneuvers. A newly available technique called volumetric capnography (Vcap) allows measurement of physiological and alveolar dead space on a regular basis at the bedside...
June 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27321293/comparison-of-the-pulmonary-dead-space-fraction-derived-from-ventilator-volumetric-capnography-and-a-validated-equation-in-the-survival-prediction-of-patients-with-acute-respiratory-distress-syndrome
#6
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
https://www.readbyqxmd.com/read/27317710/capnogram-slope-and-ventilation-dead-space-parameters-comparison-of-mainstream-and-sidestream-techniques
#7
A L Balogh, F Petak, G H Fodor, J Tolnai, Z Csorba, B Babik
BACKGROUND: Capnography may provide useful non-invasive bedside information concerning heterogeneity in lung ventilation, ventilation-perfusion mismatching and metabolic status. Although the capnogram may be recorded by mainstream and sidestream techniques, the capnogram indices furnished by these approaches have not previously been compared systematically. METHODS: Simultaneous mainstream and sidestream time and volumetric capnography was performed in anaesthetized, mechanically ventilated patients undergoing elective heart surgery...
July 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27199318/detection-of-optimal-peep-for-equal-distribution-of-tidal-volume-by-volumetric-capnography-and-electrical-impedance-tomography-during-decreasing-levels-of-peep-in-post-cardiac-surgery-patients
#8
P Blankman, A Shono, B J M Hermans, T Wesselius, D Hasan, D Gommers
BACKGROUND: Homogeneous ventilation is important for prevention of ventilator-induced lung injury. Electrical impedance tomography (EIT) has been used to identify optimal PEEP by detection of homogenous ventilation in non-dependent and dependent lung regions. We aimed to compare the ability of volumetric capnography and EIT in detecting homogenous ventilation between these lung regions. METHODS: Fifteen mechanically-ventilated patients after cardiac surgery were studied...
June 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27145818/assessment-of-dead-space-ventilation-in-patients-with-acute-respiratory-distress-syndrome-a-prospective-observational-study
#9
Jonne Doorduin, Joeke L Nollet, Manon P A J Vugts, Lisanne H Roesthuis, Ferdi Akankan, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Physiological dead space (VD/VT) represents the fraction of ventilation not participating in gas exchange. In patients with acute respiratory distress syndrome (ARDS), VD/VT has prognostic value and can be used to guide ventilator settings. However, VD/VT is rarely calculated in clinical practice, because its measurement is perceived as challenging. Recently, a novel technique to calculate partial pressure of carbon dioxide in alveolar air (PACO2) using volumetric capnography (VCap) was validated...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27042039/copd-phenotypes-on-computed-tomography-and-its-correlation-with-selected-lung-function-variables-in-severe-patients
#10
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
https://www.readbyqxmd.com/read/26928760/capnographic-parameters-in-ventilated-patients-correspondence-with-airway-and-lung-tissue-mechanics
#11
Zsofia Csorba, Ferenc Petak, Kitti Nevery, Jozsef Tolnai, Adam L Balogh, Ferenc Rarosi, Gergely H Fodor, Barna Babik
BACKGROUND: Although the mechanical status of the lungs affects the shape of the capnogram, the relations between the capnographic parameters and those reflecting the airway and lung tissue mechanics have not been established in mechanically ventilated patients. We, therefore, set out to characterize how the mechanical properties of the airways and lung tissues modify the indices obtained from the different phases of the time and volumetric capnograms and how the lung mechanical changes are reflected in the altered capnographic parameters after a cardiopulmonary bypass (CPB)...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26828240/increased-volume-of-conducting-airways-in-idiopathic-pulmonary-fibrosis-is-independent-of-disease-severity-a-volumetric-capnography-study
#12
Laurent Plantier, Marie-Pierre Debray, Candice Estellat, Martin Flamant, Carine Roy, Catherine Bancal, Raphaël Borie, Dominique Israël-Biet, Hervé Mal, Bruno Crestani, Christophe Delclaux
Bronchiectasis, bronchiolectasis, and bronchiolisation of alveolar regions are salient features of idiopathic pulmonary fibrosis (IPF). We asked whether IPF was associated with physiological changes consistent with increases in the volume of conducting airways, and whether airway volume was related to the severity of lung fibrosis. Patients with IPF (N  =  57, vital capacity-VC: 73  ±  20%), patients with non-IPF interstitial lung disease (non-IPF ILD, N  =  24, VC  =  78  ±  18%) and controls without lung disease (N  =  51, VC  =  112  ±  21%) underwent volumetric capnography for the determination of conducting airway volume using Fletcher's equal area method, reported to predicted total lung capacity to control for the effect of lung size (VDaw/TLCp, mL/L)...
February 1, 2016: Journal of Breath Research
https://www.readbyqxmd.com/read/26715770/a-comparison-of-carbon-dioxide-elimination-measurements-between-a-portable-indirect-calorimeter-and-volumetric-capnography-monitor-an-in-vitro-simulation
#13
Craig D Smallwood, Enid E Martinez, Nilesh M Mehta
BACKGROUND: Gas exchange measurements for carbon dioxide elimination (V̇CO2 ) and oxygen consumption (V̇O2 ) have been used to derive resting energy expenditure and guide energy prescription. Volumetric capnography is used in intensive care units and provides V̇CO2 measurements that could be used for titrating respiratory and nutritional support. We have recently suggested that measuring V̇CO2 may be sufficient to obtain a reasonable estimate of energy expenditure. However, data describing the accuracy of gas exchange measurement devices are limited...
March 2016: Respiratory Care
https://www.readbyqxmd.com/read/26599006/methacholine-induced-variations-in-airway-volume-and-the-slope-of-the-alveolar-capnogram-are-distinctly-associated-with-airflow-limitation-and-airway-closure
#14
Laurent Plantier, Sylvain Marchand-Adam, Laurent Boyer, Camille Taillé, Christophe Delclaux
Mechanisms driving alteration of lung function in response to inhalation of a methacholine aerosol are incompletely understood. To explore to what extent large and small airways contribute to airflow limitation and airway closure in this context, volumetric capnography was performed before (n = 93) and after (n = 78) methacholine provocation in subjects with an intermediate clinical probability of asthma. Anatomical dead space (VDaw), reflecting large airway volume, and the slope of the alveolar capnogram (slope3), an index of ventilation heterogeneity linked to small airway dysfunction, were determined...
2015: PloS One
https://www.readbyqxmd.com/read/26215805/effect-of-body-position-on-ventilation-distribution-during-peep-titration-in-a-porcine-model-of-acute-lung-injury-using-advanced-respiratory-monitoring-and-electrical-impedance-tomography
#15
Klaus Pfurtscheller, Stefan Ring, Elisabeth Beran, Erich Sorantin, Joachim Zobel, David Ganster, Alexander Avian, Gerfried Zobel
BACKGROUND: Lung failure after acute lung injury remains a challenge in different clinical settings. Various interventions for restoration of gas exchange have been investigated. Recruitment of collapsed alveoli by positive end expiratory pressure (PEEP) titration and optimization of ventilation-perfusion ratio by prone positioning have been extensively described in animal and clinical trials. This animal study was conducted to investigate the effects of PEEP and positioning by means of advanced respiratory monitoring including gas exchange, respiratory mechanics, volumetric capnography and electrical impedance tomography...
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/26199451/monitoring-dead-space-in-mechanically-ventilated-children-volumetric-capnography-versus-time-based-capnography
#16
Anoopindar K Bhalla, Sarah Rubin, Christopher J L Newth, Patrick Ross, Rica Morzov, Gerardo Soto-Campos, Robinder Khemani
BACKGROUND: Volumetric capnography dead-space measurements (physiologic dead-space-to-tidal-volume ratio [VD/VT] and alveolar VD/VT) are considered more accurate than the more readily available time-based capnography dead-space measurement (end-tidal alveolar dead-space fraction [AVDSF]). We sought to investigate the correlation between volumetric capnography and time-based capnography dead-space measurements. METHODS: This was a single-center prospective cohort study of 65 mechanically ventilated children with arterial lines...
November 2015: Respiratory Care
https://www.readbyqxmd.com/read/26178886/a-mainstream-monitoring-system-for-respiratory-co2-concentration-and-gasflow
#17
Jiachen Yang, Bobo Chen, Kyle Burk, Haitao Wang, Jianxiong Zhou
Continuous respiratory gas monitoring is an important tool for clinical monitoring. In particular, measurement of respiratory [Formula: see text] concentration and gasflow can reflect the status of a patient by providing parameters such as volume of carbon dioxide, end-tidal [Formula: see text] respiratory rate and alveolar deadspace. However, in the majority of previous work, [Formula: see text] concentration and gasflow have been studied separately. This study focuses on a mainstream system which simultaneously measures respiratory [Formula: see text] concentration and gasflow at the same location, allowing for volumetric capnography to be implemented...
August 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/25985982/ventilatory-abnormalities-in-patients-with-cystic-fibrosis-undergoing-the-submaximal-treadmill-exercise-test
#18
Paloma Lopes Francisco Parazzi, Fernando Augusto de Lima Marson, Maria Angela Gonçalves de Oliveira Ribeiro, Celize Cruz Bresciani de Almeida, Luiz Cláudio Martins, Ilma Aparecida Paschoal, Adyleia Aparecida Dalbo Contrera Toro, Camila Isabel Santos Schivinski, Jose Dirceu Ribeiro
BACKGROUND: Exercise has been studied as a prognostic marker for patients with cystic fibrosis (CF), as well as a tool for improving their quality of life and analyzing lung disease. In this context, the aim of the present study was to evaluate and compare variables of lung functioning. Our data included: (i) volumetric capnography (VCAP) parameters: expiratory minute volume (VE), volume of exhaled carbon dioxide (VCO2), VE/VCO2, ratio of dead space to tidal volume (VD/VT), and end-tidal carbon dioxide (PetCO2); (ii) spirometry parameters: forced vital capacity (FVC), percent forced expiratory volume in the first second of the FVC (FEV1%), and FEV1/FVC%; and (iii) cardiorespiratory parameters: heart rate (HR), respiratory rate, oxygen saturation (SpO2), and Borg scale rating at rest and during exercise...
2015: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/25827586/how-to-monitor-a-recruitment-maneuver-at-the-bedside
#19
REVIEW
Thomas Godet, Jean-Michel Constantin, Samir Jaber, Emmanuel Futier
PURPOSE OF REVIEW: To provide an overview on most recent knowledge on methods currently available for monitoring of recruitment maneuvers at the bedside. RECENT FINDINGS: The effects of recruitment maneuvers on clinical outcomes in patients with moderate to severe acute respiratory distress syndrome and in patients with healthy lungs undergoing major surgery were recently assessed. Despite being part of a multifaceted approach of protective ventilation, recruitment maneuvers are supposed to decrease mortality and improve postoperative outcomes...
June 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/25549487/-positive-end-expiratory-pressure-adjustment-in-parenchimal-respiratory-failure-static-pressure-volume-loop-or-transpulmonary-pressure
#20
COMPARATIVE STUDY
A I Iaroshetskiĭ, D N Protsenko, N A Rezepov, B R Gel'fand
OBJECTIVE: The aim of the study was compare the prognostic value, efficacy and safety ofpositive end-expiratory pressure (PEEP) adjustment in conformity with lower inflection point of static "pressure-volume" loop (LIP) or end-expiratory esophageal pressure (EEEP) in parenchymal respiratory failure. METHODS: We included in the study 56 patients (39 males) at age 47 +/- 17.8 years with parenchymal respiratory failure (PaO2/FiO2 < 250 mmHg, bilateral infiltrates on chest X-ray or lung CT scan, no signs of left ventricular failure), who were mecAanically ventilated for less than 48 hours...
July 2014: Anesteziologiia i Reanimatologiia
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