An abrupt reduction in end tidal carbon di oxide concentration in a mechanically ventilated patient in neurocritical care ward: a capnogram artifact.

In patients with normal lung and reasonable cardiac function such as head injury patients, the PETCo2 can be used as a surrogate for partial pressure of Carbon dioxide (PaCO2 ) in mechanically ventilated patients. Thus early interpretation and accurate assessment of capnogram is crucial in neurocritical care patients. Here we present and discuss a scenario where in connection of a jet nebulizer to the ventilator lead to abrupt decrease in end tidal carbon dioxide leading to a diagnostic dilemma. Also this report highlights and discusses the importance of the proper placement of breathing circuit components to ensure accurate CO2 readings in particular the use of a jet nebulizer.